Healthcare Provider Details

I. General information

NPI: 1689094641
Provider Name (Legal Business Name): JOSEPH MESSANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 PARK CLUB LN STE 100
WILLIAMSVILLE NY
14221-5270
US

IV. Provider business mailing address

3719 UNION RD STE 218
CHEEKTOWAGA NY
14225-4251
US

V. Phone/Fax

Practice location:
  • Phone: 716-204-1101
  • Fax: 716-204-8528
Mailing address:
  • Phone: 716-206-1503
  • Fax: 716-651-7994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number292812
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number292812
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: