National Provider Identifier
John Lafayette Deberry III, M.D.
John Lafayette Deberry III, M.D. is listed in the NPPES registry with a primary specialty of Specialist in Ambst, NY and a listed phone number of (716) 881-9077.
Profile Overview
- NPI
- 1457314197
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- April 11, 2006
- Last Updated
- November 01, 2023
Practice Location
- 2150 Wehrle Dr
- Ste 100
- Ambst, NY 14221-7099
Phone: (716) 881-9077
Mailing Address
- 3401 Orchard Park RD
- Ste C
- Orchard Park, NY 14127-1238
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1457314197
- Entity Type
- Individual
- Last Name
- Deberry
- First Name
- John
- Middle Name
- Lafayette
- Name Prefix
- Dr.
- Name Suffix
- III
- Credential
- M.D.
- Mailing Street Address
- 3401 Orchard Park RD
- Mailing Address Line 2
- Ste C
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1238
- Mailing Country
- US
- Mailing Phone
- (716) 674-3104
- Mailing Fax
- (716) 674-0666
- Practice Street Address
- 2150 Wehrle Dr
- Practice Address Line 2
- Ste 100
- Practice City
- Ambst
- Practice State
- NY
- Practice ZIP Code
- 14221-7099
- Practice Country
- US
- Practice Phone
- (716) 881-9077
- Enumeration Date
- April 11, 2006
- Last Updated
- November 01, 2023
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- February 14, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)
- Other Identifiers
- 01023385 (NY)