Provider Demographics
NPI:1518504166
Name:NOTARO, KALENE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KALENE
Middle Name:MARIE
Last Name:NOTARO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KALENE
Other - Middle Name:MARIE
Other - Last Name:BIENIEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2121 MAIN ST STE 316
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2673
Mailing Address - Country:US
Mailing Address - Phone:716-837-2400
Mailing Address - Fax:716-837-3860
Practice Address - Street 1:2121 MAIN ST STE 316
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2673
Practice Address - Country:US
Practice Address - Phone:716-837-2400
Practice Address - Fax:716-837-3860
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily