MEDICARE: MRS. CAROL H GAIR RN

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
1	163W00000X	Registered Nurse	512160-1	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1174732432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL H GAIR RN

Provider Business Mailing Address
First Line	:	8 MELANT DR
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-2823
Country	:	US
Telephone Number	:	716-662-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 SOUTHWESTERN BLVD
Second Line	:
City	:	LAKE VIEW
State	:	NY
Zip	:	14085-9642
Country	:	US
Telephone Number	:	716-627-5970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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