Provider Demographics
NPI:1447767983
Name:PLUMERI, DANIEL (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PLUMERI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1151
Mailing Address - Country:US
Mailing Address - Phone:716-332-2121
Mailing Address - Fax:716-332-2122
Practice Address - Street 1:600 HARLEM RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14224-1151
Practice Address - Country:US
Practice Address - Phone:716-332-2121
Practice Address - Fax:716-322-2122
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021727363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05335277Medicaid
NYJ400637976OtherMEDICARE PTAN