Healthcare Provider Details
I. General information
NPI: 1427025667
Provider Name (Legal Business Name): DR. NOTARO-DR. SHETTY AND ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2349 MILL ST
ALIQUIPPA PA
15001-2219
US
IV. Provider business mailing address
2349 MILL ST
ALIQUIPPA PA
15001-2219
US
V. Phone/Fax
- Phone: 724-375-5401
- Fax: 724-375-6332
- Phone: 724-375-5401
- Fax: 724-375-6332
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | PA |
VIII. Authorized Official
Name:
JOHN
NOTARO
Title or Position: OFFICER
Credential: MD
Phone: 724-375-5401