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Individual

DR. ANTHONY T. VETRANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
790 RIDGE RD FL 1, LACKAWANNA, NY 14218-1629
(716) 893-7337
(716) 893-7699
Mailing address
790 RIDGE RD FL 1, LACKAWANNA, NY 14218-1629
(716) 893-7337
(716) 893-7699

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
171758
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010199001
UNIVERA
NY
01
000510859007
BLUE CROSS
NY
05
01191877
NY
01
050728000000
FIDELIS
NY
01
119288DL
PREFERRED CARE
NY
01
1207848
INDEPENDENT HEALTH
NY
Enumeration date
07/06/2006
Last updated
04/25/2025
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