Provider Demographics
NPI:1346244027
Name:BUFFA, SALVATORE MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:MARTIN
Last Name:BUFFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:243 NORTH RD
Mailing Address - Street 2:STE 304
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1173
Mailing Address - Country:US
Mailing Address - Phone:845-451-7251
Mailing Address - Fax:845-451-7757
Practice Address - Street 1:243 NORTH RD
Practice Address - Street 2:STE 304
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1173
Practice Address - Country:US
Practice Address - Phone:845-471-9410
Practice Address - Fax:845-471-7643
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203239207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01687690Medicaid
A400024947Medicare PIN
NY730331Medicare ID - Type Unspecified