Provider Demographics
NPI:1144281056
Name:POZZUTO, ANTHONY JOSEPH (CCC SLP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:POZZUTO
Suffix:
Gender:M
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1910
Mailing Address - Country:US
Mailing Address - Phone:716-874-4500
Mailing Address - Fax:716-874-8145
Practice Address - Street 1:2128 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1910
Practice Address - Country:US
Practice Address - Phone:716-874-4500
Practice Address - Fax:716-874-8145
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000640230001OtherCOMMUNITY CARE MANAGED CA
000640230001OtherCOMMUNITY BLUE HMO STANDA
000640230001OtherCB ADVANTAGE HMO 201-203
000640230001OtherTRADITIONAL SECURE BLUE P
00027078602OtherUNIVERA COMMERCIAL
000640230001OtherHEALTHY NY HNY 201
NY01465154Medicaid
00027078602OtherASO
000640230001OtherCB LABOR HEALTH HMO 204
050421000037OtherFIDELIS CHILD HEALTH PLUS
050421000037OtherFIDELIS FAMILY HEALTH PLU
00027078602OtherSENIOR CHOICE
000640230001OtherBCBS WNY
000640230001OtherCHILD HEALTH PLUS FAMILY
050421000037OtherFIDELIS
00027078602OtherUNIVERA COMMERCIAL
000640230001OtherTRADITIONAL SECURE BLUE P