Provider Demographics
NPI:1568572246
Name:BUFFALO RHEUMATOLOGY AND MEDICINE PLLC
Entity Type:Organization
Organization Name:BUFFALO RHEUMATOLOGY AND MEDICINE PLLC
Other - Org Name:BUFFALO RHEUMATOLOGY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRISANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-675-2500
Mailing Address - Street 1:3055 SOUTHWESTERN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1231
Mailing Address - Country:US
Mailing Address - Phone:716-675-2500
Mailing Address - Fax:716-675-2590
Practice Address - Street 1:3055 SOUTHWESTERN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1231
Practice Address - Country:US
Practice Address - Phone:716-675-2500
Practice Address - Fax:716-675-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017021Medicare ID - Type Unspecified