Provider Demographics
NPI:1598718017
Name:PIETRANTONI, MASSIMO (DPM)
Entity Type:Individual
Prefix:
First Name:MASSIMO
Middle Name:
Last Name:PIETRANTONI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 WHITE SPRUCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1604
Mailing Address - Country:US
Mailing Address - Phone:585-424-2420
Mailing Address - Fax:585-424-2422
Practice Address - Street 1:382 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1604
Practice Address - Country:US
Practice Address - Phone:585-424-2420
Practice Address - Fax:585-424-2422
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005428213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5281040001Medicare PIN
NYRA5121Medicare PIN
NYU70983Medicare UPIN