Organization Active NPI

Kidsalliance Pediatric Group, LLP

  • Pediatrics Physician
  • Buffalo, NY
National Provider Identifier
1508835398
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDSALLIANCE PEDIATRIC GROUP, LLP
Practice address
565 Abbott Rd
Buffalo, NY 14220-2039
Phone
(716) 828-2568
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Vetrano, M.D.
Title
Physician
Phone
(716) 828-2568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

565 Abbott Rd
Buffalo, NY 14220-2039

Mailing address

50 Alcona Ave
Amherst, NY 14226-2201
Phone (716) 834-1191

Other identifiers 1

IdentifierTypeStateIssuer
02370230MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1508835398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ALCONA AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262201",
            "telephone_number": "716-834-1191",
            "fax_number": "716-834-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142202039",
            "telephone_number": "716-828-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSALLIANCE PEDIATRIC GROUP, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "VETRANO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "716-828-2568",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02370230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.