Provider Demographics
NPI:1790734093
Name:PISCATELLI, JAMES J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:PISCATELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-631-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187403-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherEMPIRE
NY187403-1WOtherWORKERS COMPENSATION
NY00010195903OtherUNIVERA
NY0404260011224OtherFIDELIS
NY2307925OtherIHA
NY161000580OtherNOVA
NY000524085006OtherHEALTH NOW
NY161000580OtherNORTH AMERICAN PREFERRED
NY161000580OtherUNITED HEALTHCARE OF UPST
NYP00042147OtherRR MEDICARE
NY01627141Medicaid
NY161000580OtherAETNA
NYF80080Medicare UPIN
NY01627141Medicaid