MARY JANE PETRUZZI MD NPI 1639252075

NPI Information

NPI: 1639252075
Provider Name: MARY JANE PETRUZZI, MD
Classification: Pediatrics - 2080P0207X
Entity Type: Individual

Specialization: Pediatric Hematology-Oncology

Address:
219 BRYANT ST
BUFFALO, NY
ZIP 14222
Phone: (716) 878-7349
Get Directions

Mary Jane Petruzzi, MD is a pediatric hematology-oncology pediatrics in Buffalo, NY. The provider is a pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. Mary Jane Petruzzi, MD NPI is 1639252075. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

219 BRYANT ST
BUFFALO, NY
ZIP 14222-006
Phone: (716) 878-7349
Fax: (716) 888-3801

The enumeration date for this NPI number is 10/21/2006 and was last updated on 9/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0207X	Pediatrics	Pediatric Hematology-Oncology	179829	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00010137401	OTHER		UNIVERA
2	1206399	OTHER		IHA
3	BB6199	MEDICARE PIN
4	0015503720001	OTHER		PA MEDICAID
5	040426001061	OTHER		FIDELIS
6	F91604	MEDICARE UPIN
7	000524343001	OTHER		BC/BS
8	01169979	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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