National Provider Identifier

Michael D Lacivita, DPM

Michael D Lacivita, DPM is listed in the NPPES registry with a primary specialty of Foot Surgery Podiatrist in Williamsville, NY and a listed phone number of (716) 630-1295.

NPI 1285651018Williamsville, NYFoot Surgery Podiatrist

Profile Overview

NPI
1285651018
Provider Type
Individual
Primary Specialty
Foot Surgery Podiatrist
Enumeration Date
July 17, 2006
Last Updated
July 25, 2019

Practice Location

  • 6325 Main St
  • Suite 200
  • Williamsville, NY 14221-5822

Phone: (716) 630-1295

Mailing Address

  • 425 Essjay RD Ste 170
  • Williamsville, NY 14221-8235

Specialties

  • Foot Surgery Podiatrist (213ES0131X)
  • Podiatrist (213E00000X)
Full Record
NPI
1285651018
Entity Type
Individual
Last Name
Lacivita
First Name
Michael
Middle Name
D
Credential
DPM
Mailing Street Address
425 Essjay RD Ste 170
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-8235
Mailing Country
US
Mailing Phone
(716) 630-1219
Mailing Fax
(716) 817-1726
Practice Street Address
6325 Main St
Practice Address Line 2
Suite 200
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221-5822
Practice Country
US
Practice Phone
(716) 630-1295
Practice Fax
(716) 250-5999
Enumeration Date
July 17, 2006
Last Updated
July 25, 2019
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Foot Surgery Podiatrist (213ES0131X), Podiatrist (213E00000X)
Other Identifiers
02676171 (NY)