National Provider Identifier
Timothy Dezastro, MD
Timothy Dezastro, MD is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician in Buffalo, NY and a listed phone number of (716) 855-2866.
Profile Overview
- NPI
- 1598723017
- Provider Type
- Individual
- Primary Specialty
- Diagnostic Radiology Physician
- Enumeration Date
- May 03, 2006
- Last Updated
- May 13, 2008
Practice Location
- 222 Genesee St
- Buffalo, NY 14203
Phone: (716) 855-2866
Mailing Address
- PO Box 8000
- Dept 836
- Buffalo, NY 14267
Specialties
- Diagnostic Radiology Physician (2085R0202X)
Full Record
- NPI
- 1598723017
- Entity Type
- Individual
- Last Name
- Dezastro
- First Name
- Timothy
- Credential
- MD
- Mailing Street Address
- PO Box 8000
- Mailing Address Line 2
- Dept 836
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14267
- Mailing Country
- US
- Practice Street Address
- 222 Genesee St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203
- Practice Country
- US
- Practice Phone
- (716) 855-2866
- Practice Fax
- (716) 855-2860
- Enumeration Date
- May 03, 2006
- Last Updated
- May 13, 2008
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Diagnostic Radiology Physician (2085R0202X)
- Other Identifiers
- CRDRA178121 (NY, Workers Compensation), P00003640 (Railroad Medicare), 000525009025 (Blue Shield Of Western Ny), 145797FF (Preferred Care), 000525009022 (Blue Shield Of Western Ny), RB6952 (Medicare), 000525009016 (Blue Shield Of Western Ny), 01607547 (NY), 300138602 (Railroad Medicare), 5609880 (Independent Health)