Provider Demographics
NPI:1699771832
Name:DEE, ANTHONY S (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:S
Last Name:DEE
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 1:9276 MAIN ST STE 1A
Mailing Address - Street 2:PO BOX 554
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-0554
Mailing Address - Country:US
Mailing Address - Phone:716-759-7759
Mailing Address - Fax:716-759-1759
Practice Address - Street 1:9276 MAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-0554
Practice Address - Country:US
Practice Address - Phone:716-759-7759
Practice Address - Fax:716-759-1759
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214167-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02389751Medicaid
NYBA0208Medicare ID - Type Unspecified
NY02389751Medicaid