Healthcare Provider Details

I. General information

NPI: 1306021233
Provider Name (Legal Business Name): GINA M MCCAFFREY SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5869 WEST ST
SANBORN NY
14132-9246
US

IV. Provider business mailing address

5869 WEST ST
SANBORN NY
14132-9246
US

V. Phone/Fax

Practice location:
  • Phone: 716-628-8810
  • Fax:
Mailing address:
  • Phone: 716-628-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number011417-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: