Provider Demographics
NPI:1922111236
Name:NOTARO, THOMAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:NOTARO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7268 KATIE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120
Mailing Address - Country:US
Mailing Address - Phone:716-990-3037
Mailing Address - Fax:
Practice Address - Street 1:2283 GRAND ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1819
Practice Address - Country:US
Practice Address - Phone:716-773-2222
Practice Address - Fax:716-773-4265
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009041-3111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY205314092OtherNORTH AMERICAN ADMIN.
NY000225223003OtherBLUE CROSS BLUE SHIELD
NY00040007102OtherUNIVERA
NY611040800OtherUS DEPT OF LABOR
NYIA0937OtherMEDICARE
NYP00305508OtherRAILROAD MEDICARE
NY205314092OtherAETNA
NY421664758OtherNOVA
NY000225223003OtherCOMMUNITY BLUE
NY5897344OtherGHI
NYHC09041-7OtherWORKERS COMP'/NO-FAULT
NY8890392OtherINDEPENDENT HEALTH
NYU72009Medicare UPIN
NYHC09041-7OtherWORKERS COMP'/NO-FAULT