Healthcare Provider Details

I. General information

NPI: 1609905819
Provider Name (Legal Business Name): G&P GYNECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 CENTRAL AVE
DUNKIRK NY
14048-2125
US

IV. Provider business mailing address

306 CENTRAL AVE
DUNKIRK NY
14048-2125
US

V. Phone/Fax

Practice location:
  • Phone: 716-366-4210
  • Fax: 716-366-3549
Mailing address:
  • Phone: 716-366-4210
  • Fax: 716-366-3549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number151520
License Number StateNY

VIII. Authorized Official

Name: MS. GERRY M VACANTI
Title or Position: OFFICE MANAGER
Credential:
Phone: 716-366-4210