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General NPI Number Information
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NPI Number | 1932392412
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Entity Type | Organization
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Legal Business Name | BUFFALO SPINE SURGERY, PLLC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 46 DAVISON CT
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City | LOCKPORT
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State | NY
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Zip | 14094-5370
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Country | US
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Telephone | 716-438-2973
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Fax | 716-438-9267
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Provider Business Mailing Address
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Address Line | 46 DAVISON CT
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City | LOCKPORT
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State | NY
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Zip | 14094-5370
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Country | US
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Telephone | 716-438-2973
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Fax | 716-438-9267
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW CAPPUCCINO
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Credential | MD
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Telephone | 716-438-2973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 196141-1
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License Number State | NY
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