Healthcare Provider Details

I. General information

NPI: 1629089081
Provider Name (Legal Business Name): FINGER LAKES EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US

IV. Provider business mailing address

PO BOX 13766
PHILADELPHIA PA
19101-3766
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-7121
  • Fax:
Mailing address:
  • Phone: 800-444-7009
  • Fax: 800-305-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH H. GATEWOOD
Title or Position: PRESIDENT
Credential: MD
Phone: 800-444-7009