1730392564 NPI number — PETER ACCETTA, M.D.

Table of content: DR. KENT EDWARD KARRAS DC (NPI 1528139789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730392564 NPI number — PETER ACCETTA, M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER ACCETTA, M.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730392564
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3045 SOUTHWESTERN BLVD STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORCHARD PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14127-1209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-675-7000
Provider Business Mailing Address Fax Number:
716-674-4659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3065 SOUTHWESTERN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORCHARD PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14127-1239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-675-7000
Provider Business Practice Location Address Fax Number:
716-675-7004
Provider Enumeration Date:
05/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ACCETTA
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE PROPRITOR
Authorized Official Telephone Number:
716-675-7000

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)