Healthcare Provider Details

I. General information

NPI: 1891958633
Provider Name (Legal Business Name): PETER J FILOCAMO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 MAPLE RD
WILLIAMSVILLE NY
14221-3698
US

IV. Provider business mailing address

30 S CAYUGA RD
WILLIAMSVILLE NY
14221-6728
US

V. Phone/Fax

Practice location:
  • Phone: 716-568-3600
  • Fax:
Mailing address:
  • Phone: 716-632-1088
  • Fax: 716-632-7842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number266922
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: