MEDICARE: MR. GARY GROSNER M.D.

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
1	174400000X	Specialist	1657211	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1699768283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY GROSNER M.D.

Provider Business Mailing Address
First Line	:	100 HIGH ST
Second Line	:	C3
City	:	BUFFALO
State	:	NY
Zip	:	14203-1126
Country	:	US
Telephone Number	:	716-859-2243
Fax Number	:	716-859-2885

Provider Business Practice Location Address
First Line	:	100 HIGH ST
Second Line	:	C3
City	:	BUFFALO
State	:	NY
Zip	:	14203-1126
Country	:	US
Telephone Number	:	716-859-2243
Fax Number	:	716-859-2885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	05/07/2015

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Directions to “ MR. GARY GROSNER M.D.” Practice Location

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