Provider Demographics
NPI:1548374010
Name:NOTARO, GREGORY (RPH)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:NOTARO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 ORCHARD PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4624
Mailing Address - Country:US
Mailing Address - Phone:716-675-4133
Mailing Address - Fax:716-675-1314
Practice Address - Street 1:1769 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4624
Practice Address - Country:US
Practice Address - Phone:716-675-4133
Practice Address - Fax:716-675-1314
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist