Individual
DR. ANTHONY ANGELO RACANIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6722 ERIE RD, DERBY, NY 14047-9670
(716) 947-2097
(716) 947-5909
Mailing address
5130 E MAIN STREET RD, PO BOX 803, BATAVIA, NY 14020-3496
(716) 947-2097
(716) 947-5909
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
188585
NY
2084P0802X
Addiction Psychiatry Physician
188585
NY
2084P0805X
Geriatric Psychiatry Physician
188585
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01629212
—
NY
Enumeration date
05/25/2006
Last updated
03/02/2017
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