Provider Demographics
NPI:1609760818
Name:BUCOLO, SANTO III
Entity type:Individual
Prefix:
First Name:SANTO
Middle Name:
Last Name:BUCOLO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 ELMWOOD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1669
Mailing Address - Country:US
Mailing Address - Phone:845-750-5326
Mailing Address - Fax:
Practice Address - Street 1:291 ELM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1621
Practice Address - Country:US
Practice Address - Phone:716-854-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker