Provider Demographics
NPI:1073542270
Name:CENTURY AIRPORT PEDIATRICS P.C.
Entity Type:Organization
Organization Name:CENTURY AIRPORT PEDIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:VETRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-893-7337
Mailing Address - Street 1:2625 HARLEM RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4031
Mailing Address - Country:US
Mailing Address - Phone:716-893-7337
Mailing Address - Fax:716-893-7699
Practice Address - Street 1:2625 HARLEM RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-893-7337
Practice Address - Fax:716-893-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty