Provider Demographics
NPI:1871581454
Name:STINZIANO, GERALD D (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:D
Last Name:STINZIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:897 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2007
Mailing Address - Country:US
Mailing Address - Phone:716-883-6800
Mailing Address - Fax:716-883-6853
Practice Address - Street 1:897 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2007
Practice Address - Country:US
Practice Address - Phone:716-883-6800
Practice Address - Fax:716-883-6853
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1071431173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010173301OtherUNIVERA
NY000506822001OtherBLUE CROSS/BLUE SHIELD
NY1002488OtherINDEPENDENT HEALTH
NY0046122OtherGHI
NY1002488OtherINDEPENDENT HEALTH
NY000506822001OtherBLUE CROSS/BLUE SHIELD