Provider Demographics
NPI:1083942783
Name:DAVID P VONA DPM, LLC
Entity Type:Organization
Organization Name:DAVID P VONA DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:VONA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:716-517-5069
Mailing Address - Street 1:12655 SENECA RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081-9750
Mailing Address - Country:US
Mailing Address - Phone:716-649-0887
Mailing Address - Fax:716-646-4611
Practice Address - Street 1:12655 SENECA RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081-9750
Practice Address - Country:US
Practice Address - Phone:716-649-0887
Practice Address - Fax:716-646-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100008992Medicare PIN