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General NPI Number Information
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NPI Number | 1598828733
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Entity Type | Individual
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Provider Name | ANTHONY LOUIS BUSCAGLIA D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 5430 MAIN ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6648
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Country | US
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Telephone | 716-204-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 MAJESTIC WOODS DR
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1174
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Country | US
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Telephone | 716-430-0094
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036105905
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License Number State | IL
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