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NPI Code Detail

MEDICARE: DR. DANIELLE A DEGAETANO D.O

MEDICARE: DR. DANIELLE A DEGAETANO D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician253846NY

General Provider Information

NPI Number : 1629291216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE A DEGAETANO D.O
Provider Business Mailing Address
First Line : 56 BARTEAU AVE
Second Line :
City : BLUE POINT
State : NY
Zip : 11715-1624
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 JOHN JAMES AUDUBON PKWY
Second Line :
City : AMHERST
State : NY
Zip : 14228-1143
Country : US
Telephone Number : 716-204-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 02/01/2013

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