Provider Demographics
NPI:1508946377
Name:BUFFONE, WILLIAM F (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:BUFFONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:44210 ROUTE 48
Mailing Address - City:SOUTHOLD
Mailing Address - State:NY
Mailing Address - Zip Code:11971-0933
Mailing Address - Country:US
Mailing Address - Phone:631-765-6777
Mailing Address - Fax:631-765-6933
Practice Address - Street 1:44210 ROUTE 48
Practice Address - Street 2:
Practice Address - City:SOUTHOLD
Practice Address - State:NY
Practice Address - Zip Code:11971-0933
Practice Address - Country:US
Practice Address - Phone:631-765-6777
Practice Address - Fax:631-765-6933
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0044431213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010004443OtherBC BS
NY100882926OtherCDPHP
NY000900397000OtherHEALTH NOW DME
NY01176067Medicaid
NYP044439BOtherNY WORKERS COMP
NY0004265301OtherAETNA
NY000910663001OtherHEALTH NOW
NY0069621OtherGHI
NYP5105OtherEMPIRE PLAN
NY100882926OtherCDPHP
T97965Medicare UPIN
NYP01971Medicare PIN