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General NPI Number Information
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NPI Number | 1174506836
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Entity Type | Individual
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Provider Name | RICHARD J CORBELLI MD
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Gender | Male
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Dates
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Enumeration Date | 11/26/2005
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 295 ESSJAY RD BUFFALO MEDICAL GROUP, PC
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-8216
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Country | US
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Telephone | 716-630-1146
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Fax | 716-817-1742
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Provider Business Mailing Address
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Address Line | 6255 SHERIDAN DR SUITE 108 - CREDENTIALING DEPT
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4836
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Country | US
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Telephone | 716-630-1219
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Fax | 716-817-1726
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 154527
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 154527
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License Number State | NY
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