Provider Demographics
NPI:1992761035
Name:RALABATE, JOSEPH ANGELO (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANGELO
Last Name:RALABATE
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 1:2950 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1304
Mailing Address - Country:US
Mailing Address - Phone:716-447-6100
Mailing Address - Fax:
Practice Address - Street 1:2950 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1304
Practice Address - Country:US
Practice Address - Phone:716-447-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107317208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161138026OtherEMPIRE PLAN
NY442021800OtherRAILROAD MEDICARE
NY00641474Medicaid
NY0700716OtherINDEPENDENT HEALTH
NY0005590OtherGHI
NY161138026OtherUNITED HEALTH CARE
NY00010143601OtherUNIVERA
NY000507328001OtherBLUE CROSS & BLUE SHIELD
NY000507328001OtherBLUE CROSS & BLUE SHIELD
NY0005590OtherGHI