Healthcare Provider Details
I. General information
NPI: 1528072709
Provider Name (Legal Business Name): MAPLE GATE ANESTHESIOLOGISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2568 WALDEN AVE STE 103-105
CHEEKTOWAGA NY
14225-4760
US
IV. Provider business mailing address
2568 WALDEN AVE STE 103-105
CHEEKTOWAGA NY
14225-4760
US
V. Phone/Fax
- Phone: 716-632-1088
- Fax: 716-632-7842
- Phone: 716-632-1088
- Fax: 716-632-7842
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
FILOCAMO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 716-632-1088