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General NPI Number Information
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NPI Number | 1699768283
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Entity Type | Individual
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Provider Name | GARY GROSNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 100 HIGH ST C3
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City | BUFFALO
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State | NY
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Zip | 14203-1126
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Country | US
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Telephone | 716-859-2243
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Fax | 716-859-2885
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Provider Business Mailing Address
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Address Line | 100 HIGH ST C3
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City | BUFFALO
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State | NY
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Zip | 14203-1126
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Country | US
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Telephone | 716-859-2243
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Fax | 716-859-2885
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1657211
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License Number State | NY
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