1548249832 NPI number — DR. DOMINIC A CIMATO D.O.

Table of content: DR. DOMINIC A CIMATO D.O. (NPI 1548249832)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548249832 NPI number — DR. DOMINIC A CIMATO D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CIMATO
Provider First Name:
DOMINIC
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548249832
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6255 SHERIDAN DR
Provider Second Line Business Mailing Address:
SUITE 304
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-4836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-857-8666
Provider Business Mailing Address Fax Number:
716-857-8944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 ESSJAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-8216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-877-3007
Provider Business Practice Location Address Fax Number:
716-877-3812
Provider Enumeration Date:
01/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  192038-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 161000580 . This is a "NORTH AMERICAN PREFERRED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161000580 . This is a "EMPIE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: F63161 , issued by the state of ( NY ) . This identifiers is of the category "MEDICARE UPIN".
  • Identifier: 0106303 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01545702 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000511817002 . This is a "HEALTH NOW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00010032002 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CC3516 , issued by the state of ( NY ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 0510280000024 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161000580 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".