Provider Demographics
NPI:1285677880
Name:JUETTE, PAUL HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HENRY
Last Name:JUETTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6 FOUNTAIN PLZ
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-2211
Mailing Address - Country:US
Mailing Address - Phone:716-691-8838
Mailing Address - Fax:716-564-1134
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-691-8838
Practice Address - Fax:716-564-1134
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY174048207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00040977901OtherUNIVERA
NY000523978006OtherBLUE CROSS BLUE SHIELD
NY040426000526OtherFIDELIS
NY110124030OtherRAILROAD MEDICARE
NY3990920OtherINDEPENDENT HEALTH
NY01153617Medicaid
NY01153617Medicaid