Healthcare Provider Details

I. General information

NPI: 1992974232
Provider Name (Legal Business Name): WILLIAM F BUFFONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44210 ROUTE 48
SOUTHOLD NY
11971
US

IV. Provider business mailing address

PO BOX 1146
SOUTHOLD NY
11971-0933
US

V. Phone/Fax

Practice location:
  • Phone: 631-765-6777
  • Fax: 631-765-6933
Mailing address:
  • Phone: 631-765-6777
  • Fax: 631-765-6933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN004443
License Number StateNY

VIII. Authorized Official

Name: DR. WILLIAM F BUFFONE
Title or Position: OWNER
Credential: DPM
Phone: 631-765-6777