Individual
THOMAS D POLISOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 ORCHARD PARK RD, BUILDING C, WEST SENECA, NY 14224-2646
(716) 558-5153
Mailing address
338 HARRIS HILL RD, SUITE 207, BUFFALO, NY 14221-7470
(716) 634-4798
(716) 634-0987
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
174476-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01074657
—
NY
Enumeration date
02/13/2006
Last updated
01/31/2012
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