Provider Demographics
NPI:1619968302
Name:GIUSEPPETTI, MARY M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:GIUSEPPETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1185 SWEET HOME RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1018
Mailing Address - Country:US
Mailing Address - Phone:716-689-0040
Mailing Address - Fax:716-568-2337
Practice Address - Street 1:1185 SWEET HOME RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1018
Practice Address - Country:US
Practice Address - Phone:716-689-0040
Practice Address - Fax:716-568-2337
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1795942080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BG7149126OtherDEA NUMBER