Provider Demographics
NPI:1265463715
Name:RONALD PALAZZO, M.D., P.C.
Entity Type:Organization
Organization Name:RONALD PALAZZO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-662-9045
Mailing Address - Street 1:3671 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1752
Mailing Address - Country:US
Mailing Address - Phone:716-662-9045
Mailing Address - Fax:716-662-9012
Practice Address - Street 1:3671 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1752
Practice Address - Country:US
Practice Address - Phone:716-662-9045
Practice Address - Fax:716-662-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1233Medicare ID - Type UnspecifiedMEDICARE