Basic Information
| Provider Information | |||||||||
| NPI: | 1134114051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICOTTONE | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3085 HARLEM RD | ||||||||
| Address2: | STE 350 | ||||||||
| City: | CHEEKTOWAGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142252591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168445600 | ||||||||
| FaxNumber: | 7168445750 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 STERLING DR | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166772273 | ||||||||
| FaxNumber: | 7166772477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2005 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 1996071 | NY | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 01732609 | 05 | NY | MEDICAID | 161511795 | 01 | NY | NOVA | OTHER | 161511795 | 01 | NY | NORTH AMERICAN | OTHER | 1908978 | 01 | NY | INDEPENDENT HEALTH | OTHER | 00010298601 | 01 | NY | UNIVERA | OTHER | 161511795 | 01 | NY | HUMANA | OTHER | 340015685 | 01 | NY | RAILROAD MEDICARE | OTHER | 005246462 | 01 | NY | COMMUNITY BLUE | OTHER | 2002 | 01 | NY | BLUE CROSS ROCHESTER | OTHER | MDE166 | 01 | NY | PREFERRED CARE | OTHER | 161511795 | 01 | NY | UNITED HEALTHCARE EMPIRE | OTHER | P010199607 | 01 | NY | BLUE CHOICE | OTHER |