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General NPI Number Information
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NPI Number | 1982098679
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Entity Type | Organization
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Legal Business Name | PONE RHEUMATOLOGY PLLC
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 832 WALDEN AVE
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City | BUFFALO
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State | NY
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Zip | 14211-2639
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Country | US
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Telephone | 716-381-9046
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Fax | 716-381-9046
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Provider Business Mailing Address
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Address Line | 832 WALDEN AVE
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City | BUFFALO
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State | NY
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Zip | 14211-2639
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Country | US
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Telephone | 716-381-9046
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Fax | 716-381-9046
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ENTELA PONE
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Credential | M.D.
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Telephone | 716-381-9046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 272508
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License Number State | NY
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