Healthcare Provider Details

I. General information

NPI: 1518504166
Provider Name (Legal Business Name): KALENE MARIE NOTARO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALENE MARIE BIENIEK NP

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MAIN ST STE 316
BUFFALO NY
14214-2673
US

IV. Provider business mailing address

2121 MAIN ST STE 316
BUFFALO NY
14214-2673
US

V. Phone/Fax

Practice location:
  • Phone: 716-837-2400
  • Fax: 716-837-3860
Mailing address:
  • Phone: 716-837-2400
  • Fax: 716-837-3860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF345073
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: