Basic Information
| Provider Information | |||||||||
| NPI: | 1548249832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIMATO | ||||||||
| FirstName: | DOMINIC | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6255 SHERIDAN DR | ||||||||
| Address2: | SUITE 304 | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142214836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168578666 | ||||||||
| FaxNumber: | 7168578944 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 ESSJAY RD | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142218216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168773007 | ||||||||
| FaxNumber: | 7168773812 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 11/05/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 192038-1 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 161000580 | 01 | NY | NORTH AMERICAN PREFERRED | OTHER | 0106303 | 01 | NY | IHA | OTHER | 000511817002 | 01 | NY | HEALTH NOW | OTHER | 0510280000024 | 01 | NY | FIDELIS | OTHER | 161000580 | 01 | NY | CIGNA | OTHER | 00010032002 | 01 | NY | UNIVERA | OTHER | 161000580 | 01 | NY | EMPIE PLAN | OTHER | 01545702 | 05 | NY | MEDICAID |