Healthcare Provider Details

I. General information

NPI: 1831498476
Provider Name (Legal Business Name): EMILY C DENISCO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY PULLI D.O.

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 02/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S CAYUGA RD
WILLIAMSVILLE NY
14221-6728
US

IV. Provider business mailing address

30 S CAYUGA RD
WILLIAMSVILLE NY
14221-6728
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-1088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number279452
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: