Healthcare Provider Details

I. General information

NPI: 1154383032
Provider Name (Legal Business Name): AARON GARBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W TAFT RD SUITE 1C
LIVERPOOL NY
13088-3807
US

IV. Provider business mailing address

5100 W TAFT RD SUITE 1C
LIVERPOOL NY
13088-3807
US

V. Phone/Fax

Practice location:
  • Phone: 315-452-2333
  • Fax: 315-452-2336
Mailing address:
  • Phone: 315-452-2333
  • Fax: 315-452-2336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number212664
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number212664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: