| Organization Name: | PHYSICIANS PRACTICE OF EASTERN NIAGARA PC |
| NPI Number: | 1053733915 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL ICKOWSKI (CFO) |
| Mailing Address: | 15 Elizabeth Dr Lockport |
| State: | NY US |
| Postal Code: | 140945226 |
| Phone Number: | 7166923302 |
| Fax Number: | 7162130935 |
| NPI Enumeration Date: | 01/13/2014 |
| NPI Last Update Date: | 01/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0102X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Surgical Critical Care |
| Taxonomy Definition: | A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |