Individual
MARIE A IACONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3435 BAILEY AVE, BUFFALO, NY 14215-1145
(716) 835-2981
Mailing address
3435 BAILEY AVE, BUFFALO, NY 14215-1145
(716) 835-2966
(716) 834-3901
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
176737
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01105215
—
NY
Enumeration date
07/26/2006
Last updated
05/19/2010
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