Healthcare Provider Details

I. General information

NPI: 1790790442
Provider Name (Legal Business Name): JOSEPH GELORMINI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 BAILEY AVE
BUFFALO NY
14215-1145
US

IV. Provider business mailing address

3435 BAILEY AVE
BUFFALO NY
14215-1145
US

V. Phone/Fax

Practice location:
  • Phone: 716-835-2966
  • Fax: 716-834-3901
Mailing address:
  • Phone: 716-835-2981
  • Fax: 716-834-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number155314
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: