Individual provider Active NPI

Stephen Tofano Anzalone, COTA

  • Specialist
  • Williamsville, NY
National Provider Identifier
1639315211
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
004035-1 Issued in NY
Practice address
193 S Union Rd
Williamsville, NY 14221-6531
Phone
(716) 213-7500
NPI assigned
Jan 2, 2009
Last updated
Jan 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 004035-1 NY Primary

Addresses

Primary practice location

193 S Union Rd
Williamsville, NY 14221-6531

Mailing address

7109 Ridgewoor Dr
Lockport, NY 14094
Phone (213) 566-0247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004035-1NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1639315211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 RIDGEWOOR DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "14094",
            "telephone_number": "213-566-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 S UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216531",
            "telephone_number": "716-213-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZALONE",
        "first_name": "STEPHEN",
        "middle_name": "TOFANO",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "004035-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.