Healthcare Provider Details

I. General information

NPI: 1750469110
Provider Name (Legal Business Name): PAUL J VIOLANTI PNP/FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4838 MCKINLEY PKWY
HAMBURG NY
14075-1037
US

IV. Provider business mailing address

4838 MCKINLEY PKWY
HAMBURG NY
14075-1037
US

V. Phone/Fax

Practice location:
  • Phone: 716-983-6667
  • Fax: 716-881-6247
Mailing address:
  • Phone: 716-983-6667
  • Fax: 716-881-6247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333647-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF381062-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: