Provider Demographics
NPI:1093778565
Name:VIOLANTE, JUDE S (DPM)
Entity Type:Individual
Prefix:
First Name:JUDE
Middle Name:S
Last Name:VIOLANTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 COLOMBA DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-1205
Mailing Address - Country:US
Mailing Address - Phone:716-205-0181
Mailing Address - Fax:716-297-6487
Practice Address - Street 1:1 COLOMBA DR
Practice Address - Street 2:SUITE 6
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-1205
Practice Address - Country:US
Practice Address - Phone:716-205-0181
Practice Address - Fax:716-297-6487
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN006111-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000528893004OtherBLUE CROSS DME
NY1400340OtherGHI
NY00027261503OtherUNIVERA
NY000528893003OtherBLUE CROSS OF WNY
NY000528893004OtherBLUE CROSS DME
NY000528893003OtherBLUE CROSS OF WNY
NYRA8930Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NY1400340OtherGHI
NYV05773Medicare UPIN