Healthcare Provider Details

I. General information

NPI: 1689658312
Provider Name (Legal Business Name): CELESTINO PIETRANTONI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 ESSJAY RD BUFFALO MEDICAL GROUP, PC
WILLIAMSVILLE NY
14221-8216
US

IV. Provider business mailing address

6255 SHERIDAN DR SUITE 108 - CREDENTIALING DEPT
WILLIAMSVILLE NY
14221-4836
US

V. Phone/Fax

Practice location:
  • Phone: 716-630-1146
  • Fax: 716-817-1726
Mailing address:
  • Phone: 716-630-1219
  • Fax: 716-817-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number223235
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: