Provider Demographics
NPI:1013027846
Name:ADORNETTO, GREGORY J (DPM)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:ADORNETTO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:179 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5004
Mailing Address - Country:US
Mailing Address - Phone:716-649-2892
Mailing Address - Fax:716-649-2956
Practice Address - Street 1:179 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5004
Practice Address - Country:US
Practice Address - Phone:716-649-2892
Practice Address - Fax:716-649-2956
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2891-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00897585Medicaid
NY000500710001OtherBLUECROSS/BLUESHIELD
NY00010250701OtherLIFETIME HEALTH
NY480017299OtherRAILROAD MEDICARE
NY8905893OtherINDEPENDENT HEALTH
NY00897585Medicaid
NY007101Medicare PIN
NY00010250701OtherLIFETIME HEALTH