Provider Demographics
NPI:1679618284
Name:PAOLINI, JOHN ANTHONY (PA, MS, ATC, CSCS)
Entity Type:Individual
Prefix:PROF
First Name:JOHN
Middle Name:ANTHONY
Last Name:PAOLINI
Suffix:
Gender:M
Credentials:PA, MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6755
Mailing Address - Country:US
Mailing Address - Phone:716-906-5908
Mailing Address - Fax:
Practice Address - Street 1:4949 HARLEM RD
Practice Address - Street 2:UNIVERSITY ORTHOPAEDIC SERVICES, INC
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2500
Practice Address - Country:US
Practice Address - Phone:716-204-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0036712255A2300X
NY019050363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer