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NPI 1134865850

NPI 1134865850 : ALICIA NICOLE GAYLEEN DRAGO M.D. : BUFFALO, NY

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General NPI Number Information
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    NPI Number           |    1134865850
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    Entity Type          |    Individual 
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    Provider Name        |    ALICIA NICOLE GAYLEEN DRAGO M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/05/2022
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    Last Update Date     |    08/11/2025
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Provider Practice Location Address
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    Address Line         |    818 ELLICOTT ST. 
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    City                 |    BUFFALO
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    State                |    NY
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    Zip                  |    14203
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    Country              |    US
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    Telephone            |    716-323-2000
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    Fax                  |    716-323-0292
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Provider Business Mailing Address
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    Address Line         |    1001 MAIN ST FL 5 
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    City                 |    BUFFALO
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    State                |    NY
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    Zip                  |    14203-1009
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    Country              |    US
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    Telephone            |    716-323-0225
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    Fax                  |    716-323-0293
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    338745
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    License Number State |    NY
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