Provider Demographics
NPI:1245288612
Name:NOTARO, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:NOTARO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:425 ESSJAY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:3900 N BUFFALO ROAD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1842
Practice Address - Country:US
Practice Address - Phone:716-656-4806
Practice Address - Fax:716-250-5926
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-12-06
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Provider Licenses
StateLicense IDTaxonomies
NY182182-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16-1000580OtherNORTH AMERICAN PREFERRED
NY182182-6WOtherWORKERS COMPENSATION
NY161000580OtherEMPIRE
NY00010128201OtherUNIVERA
NY0407069OtherIHA
NY110114160OtherRR MEDICARE
NY161000580OtherNOVA
NY01572334Medicaid
NY000523617001OtherHEALTH NOW
NY000523617001OtherHEALTH NOW
NYQ52746Medicare PIN