Provider Demographics
NPI:1639213721
Name:DANIEL A. BUSCAGLIA, D.O., P.C.
Entity Type:Organization
Organization Name:DANIEL A. BUSCAGLIA, D.O., P.C.
Other - Org Name:THE COSMETIC VEIN & LASER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BUSCAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-839-5851
Mailing Address - Street 1:4600 MAIN ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4500
Mailing Address - Country:US
Mailing Address - Phone:716-839-5851
Mailing Address - Fax:716-839-5841
Practice Address - Street 1:4600 MAIN ST
Practice Address - Street 2:STE. 100
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4500
Practice Address - Country:US
Practice Address - Phone:716-839-5851
Practice Address - Fax:716-839-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193737-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010379901OtherUNIVERA
NY0007672065OtherAETNA
NY0192337OtherINDEPENDENT HEALTH CORP
NY0007672065OtherAETNA
F98369Medicare UPIN