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NPI Code Detail

MEDICARE: EAR,NOSE&THROAT CARE OF WNY PC

MEDICARE: EAR,NOSE&THROAT CARE OF WNY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154430387
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAR,NOSE&THROAT CARE OF WNY PC
Provider Business Mailing Address
First Line : 531 FARBER LAKES DR
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-5773
Country : US
Telephone Number : 716-634-6224
Fax Number :
Provider Business Practice Location Address
First Line : 531 FARBER LAKES DR
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-5773
Country : US
Telephone Number : 716-634-6224
Fax Number :
Authorized Official
Title or Position : OWNER PHYSICIAN
Name : DR. RAYMOND VINCENT PAOLINI JR.
Credential : M.D.
Telephone Number : 716-634-6224
Provider Enumeration Date : 08/30/2006
Last Update Date : 08/22/2020

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