Provider Demographics
NPI:1871576967
Name:ROZMUS, GRZEGORZ P (MD)
Entity type:Individual
Prefix:
First Name:GRZEGORZ
Middle Name:P
Last Name:ROZMUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5838
Mailing Address - Country:US
Mailing Address - Phone:716-634-5100
Mailing Address - Fax:716-634-5134
Practice Address - Street 1:6460 MAIN ST
Practice Address - Street 2:BUFFALO CARDIOLOGY AND PULMONARY ASSOC PC
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5838
Practice Address - Country:US
Practice Address - Phone:716-634-5100
Practice Address - Fax:716-634-5134
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229790207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026835602OtherBLUE CROSS COMMUNITY BLUE
NY2112948OtherINDEPENDENT HEALTH
NY00026835602OtherUNIVERA
NY2516925Medicaid
NY00026835602OtherUNIVERA
NY2516925Medicaid