Healthcare Provider Details

I. General information

NPI: 1801803721
Provider Name (Legal Business Name): DANIEL ANTHONY BUSCAGLIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MAIN ST STE 100
AMHERST NY
14226
US

IV. Provider business mailing address

4600 MAIN ST STE 100
AMHERST NY
14226
US

V. Phone/Fax

Practice location:
  • Phone: 716-839-5851
  • Fax: 716-839-5841
Mailing address:
  • Phone: 716-839-5851
  • Fax: 716-839-5841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1937371
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0030732801
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerUNIVERA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: