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NPI Code Detail

MEDICARE: ALLISON L GIBSON LPN

MEDICARE: ALLISON L GIBSON LPN
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
1164W00000XLicensed Practical Nurse333324-1NY

General Provider Information

NPI Number : 1720647084
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON L GIBSON LPN
Provider Business Mailing Address
First Line : 5070 BROADWAY
Second Line :
City : DEPEW
State : NY
Zip : 14043
Country : US
Telephone Number : 716-495-7341
Fax Number : 716-662-0019
Provider Business Practice Location Address
First Line : 1280 MAIN ST 1ST FLOOR
Second Line :
City : BUFFALO
State : NY
Zip : 14209-1966
Country : US
Telephone Number : 716-884-8797
Fax Number : 716-882-0293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2019
Last Update Date : 04/15/2022

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