Provider Demographics
NPI:1457319287
Name:CONDINO, DALINDA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DALINDA
Middle Name:ANN
Last Name:CONDINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 HARLEM ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3822
Mailing Address - Country:US
Mailing Address - Phone:716-839-6720
Mailing Address - Fax:716-983-6740
Practice Address - Street 1:219 BRYANT STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-1081
Practice Address - Fax:716-878-1152
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1927582080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018704240001Medicaid
NY01416715Medicaid
000524378005OtherBC/BS
040426001858OtherFIDELIS
1206036OtherIHA
000524378004OtherBC/BS
040426001857OtherFIDELIS
00010034501OtherUNIVERA
080407000146OtherFIDELIS
000524378001OtherBC/.BS
040426001857OtherFIDELIS
000524378005OtherBC/BS