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General NPI Number Information
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NPI Number | 1225297773
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Entity Type | Organization
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Legal Business Name | DEVINCENTIS,DPM-DEVINCENTIS,DPM
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 4200 N BUFFALO RD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2415
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Country | US
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Telephone | 716-662-1003
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Fax | 716-667-1315
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Provider Business Mailing Address
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Address Line | 4200 N BUFFALO RD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2415
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Country | US
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Telephone | 716-662-1003
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Fax | 716-667-1315
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY FRANCIS DEVINCENTIS SR.
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Credential | DPM
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Telephone | 716-662-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N002275-1
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License Number State | NY
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