=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376946616
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL ANTHONY NOTO PT, DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2014
-----------------------------------------------------
Last Update Date | 05/09/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 57 4TH ST # 272
-----------------------------------------------------
City | WATERFORD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12188-9998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-419-3777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 272
-----------------------------------------------------
City | WATERFORD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12188-0272
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-419-3777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 022777-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------