Healthcare Provider Details

I. General information

NPI: 1922038603
Provider Name (Legal Business Name): REPICCI AND ROMANOWSKI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 MAIN ST
BUFFALO NY
14226-3800
US

IV. Provider business mailing address

4510 MAIN ST
BUFFALO NY
14226-3800
US

V. Phone/Fax

Practice location:
  • Phone: 716-839-0632
  • Fax: 716-839-2012
Mailing address:
  • Phone: 716-839-0632
  • Fax: 716-839-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN A REPICCI
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 716-839-0632