person
Timothy Dezastro, MD
Diagnostic Radiology Physician in Buffalo, New York
NPI 1598723017

Timothy Dezastro is a Diagnostic Radiology Physician based in Buffalo, NY and is specialized in Diagnostic Radiology. Timothy Dezastro practices in Buffalo, NY and has the professional credentials of MD. The NPI Number for Timothy Dezastro is 1598723017 and holds a License No. 1781211 (New York).

The current practice location address for Timothy Dezastro is 222 Genesee St, Buffalo, NY and can be reached out via phone at 716-855-2866 and via fax at 716-855-2860.

Location: 222 Genesee St, Buffalo, NY, 14267
person
Provider Profile Details
NPI Number
1598723017
Provider Name
Timothy Dezastro
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
222 Genesee St, Buffalo, NY, 14267
Phone Number
716-855-2866
Fax Number
716-855-2860
Provider Enumeration Date
05/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CRDRA178121 01 NY WORKERS COMPENSATION
P00003640 01 RAILROAD MEDICARE
000525009025 01 BLUE SHIELD OF WESTERN NY
145797FF 01 PREFERRED CARE
000525009022 01 BLUE SHIELD OF WESTERN NY
RB6952 01 MEDICARE
000525009016 01 BLUE SHIELD OF WESTERN NY
01607547 05 NY
300138602 01 RAILROAD MEDICARE
5609880 01 INDEPENDENT HEALTH
institution
Provider Business Practice Location Address Details
Address
222 Genesee St
City
State
Zip
14203
Phone Number
716-855-2866
Fax Number
716-855-2860
person
Provider Business Mailing Address Details
Address
222 Genesee St
City
State
Zip
14203
Phone Number
716-855-2866
Fax Number
716-855-2860
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
1781211 (New York)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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