Healthcare Provider Details

I. General information

NPI: 1982058988
Provider Name (Legal Business Name): DENISE TANSIONGCO SARTORI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2016
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 MAIN ST
BUFFALO NY
14214
US

IV. Provider business mailing address

2924 MAIN ST
BUFFALO NY
14214-1720
US

V. Phone/Fax

Practice location:
  • Phone: 716-837-0995
  • Fax:
Mailing address:
  • Phone: 716-837-0995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number298039
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: