Individual
ANDREA M BUCCILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
70 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5366
(716) 434-7505
(716) 439-9084
Mailing address
70 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5366
(716) 434-7505
(716) 439-9084
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2517621
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03118054
—
NY
Enumeration date
03/23/2009
Last updated
10/18/2010
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