Provider Demographics
NPI:1689658312
Name:PIETRANTONI, CELESTINO (DO)
Entity Type:Individual
Prefix:
First Name:CELESTINO
Middle Name:
Last Name:PIETRANTONI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 108 - CREDENTIALING DEPT
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:BUFFALO MEDICAL GROUP, PC
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1146
Practice Address - Fax:716-817-1726
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223235207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026850801OtherUNIVERA
NY2812559OtherINDEP HEALTH
NY2560901Medicaid
NY000527694001OtherBLUE CROSS COMM BLUE
NYRA2722Medicare ID - Type Unspecified
NY2560901Medicaid