Healthcare Provider Details

I. General information

NPI: 1619968302
Provider Name (Legal Business Name): MARY M GIUSEPPETTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 SWEET HOME RD
AMHERST NY
14226-1018
US

IV. Provider business mailing address

1185 SWEET HOME RD
AMHERST NY
14226-1018
US

V. Phone/Fax

Practice location:
  • Phone: 716-689-0040
  • Fax: 716-568-2337
Mailing address:
  • Phone: 716-689-0040
  • Fax: 716-568-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number179594
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number179594
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: