Provider Demographics
NPI:1982636650
Name:VETRANO, ANTHONY T (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:T
Last Name:VETRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 HARLEM RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4031
Mailing Address - Country:US
Mailing Address - Phone:716-893-7337
Mailing Address - Fax:716-893-7699
Practice Address - Street 1:2625 HARLEM RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-893-7337
Practice Address - Fax:716-893-7699
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01191877Medicaid
NY050728000000OtherFIDELIS
NY119288DLOtherPREFERRED CARE
NY000510859007OtherBLUE CROSS
NY00010199001OtherUNIVERA
NY1207848OtherINDEPENDENT HEALTH