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Individual

DR. JOSEPH ANTHONY DE VINCENTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3065 SOUTHWESTERN BLVD STE 200, ORCHARD PARK, NY 14127
(716) 677-2601
(716) 677-0340
Mailing address
3065 SOUTHWESTERN BLVD STE 200, ORCHARD PARK, NY 14127-1239
(716) 677-2601
(716) 677-0340

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N002646
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010250307
UNIVERA
NY
01
000507384012
BCBS
NY
01
000507384013
BCBS
NY
01
000507384014
BCBS
NY
01
000507384015
BCBS
NY
05
00607814
NY
01
8905253
INDEPENDENT HEALTH
NY
Enumeration date
07/26/2006
Last updated
07/27/2018
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