Healthcare Provider Details

I. General information

NPI: 1174977250
Provider Name (Legal Business Name): STEPHANIE SANTORO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE CANDELORA

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 MAIN ST
BUFFALO NY
14214-2648
US

IV. Provider business mailing address

144 GENESEE ST FL 3
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-862-1984
  • Fax:
Mailing address:
  • Phone: 716-862-2360
  • Fax: 716-601-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number303689
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: