Provider Demographics
NPI:1255309902
Name:CANZONERI, JOSEPH R (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:CANZONERI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2132
Mailing Address - Country:US
Mailing Address - Phone:585-343-8150
Mailing Address - Fax:585-343-1768
Practice Address - Street 1:2 STATE ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2132
Practice Address - Country:US
Practice Address - Phone:585-343-8150
Practice Address - Fax:585-343-1768
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0004862213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8990359OtherINDEPENDENT HEALTH
NYP020004862OtherBCBS OF ROCHESTER
NY20-3146947OtherTAX ID #
NY480011943OtherRAILROAD MEDICARE
NYP010004862OtherBLUE CHOICE
NY00010250902OtherUNIVERA
NY000511401006OtherBCBS OF WNY
NY101977EQOtherPREFERRED CARE
NY5507080001OtherDMERC REGION A
NY20-3146947OtherTAX ID #
NY480011943OtherRAILROAD MEDICARE