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NPI Code Detail

MEDICARE: GAGNON ONCOLOGY, LLC

MEDICARE: GAGNON ONCOLOGY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianD0039954MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376814293
Entity Type Code : Organization
Provider Name (Legal Business Name) : GAGNON ONCOLOGY, LLC
Provider Business Mailing Address
First Line : 111 LODER ST STE B
Second Line :
City : HORNELL
State : NY
Zip : 14843-1950
Country : US
Telephone Number : 888-465-5278
Fax Number : 607-324-7615
Provider Business Practice Location Address
First Line : 1562 OPOSSUMTOWN PIKE
Second Line :
City : FREDERICK
State : MD
Zip : 21702-4920
Country : US
Telephone Number : 240-566-4500
Fax Number : 301-694-5554
Authorized Official
Title or Position : ADMINISTRATOR
Name : LYNDA D LOSECCO
Credential :
Telephone Number : 607-324-2340
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/14/2025

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