Provider Demographics
NPI:1013027663
Name:BUFFALO RHEUMATOLOGY AND MEDICINE PLLC
Entity Type:Organization
Organization Name:BUFFALO RHEUMATOLOGY AND MEDICINE PLLC
Other - Org Name:BUFFALO RHEUMATOLOGY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRISANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-675-2500
Mailing Address - Street 1:3500 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1548
Mailing Address - Country:US
Mailing Address - Phone:716-204-4263
Mailing Address - Fax:716-204-4264
Practice Address - Street 1:3500 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1548
Practice Address - Country:US
Practice Address - Phone:716-204-4263
Practice Address - Fax:716-204-4264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225612174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH82525Medicare UPIN
NY017021Medicare ID - Type Unspecified