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NPI Code Detail

MEDICARE: STEPHEN GAMMA

MEDICARE:   STEPHEN  GAMMA
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
12255A2300XAthletic Trainer003059NY

General Provider Information

NPI Number : 1922816347
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN GAMMA
Provider Business Mailing Address
First Line : 7 PURPLE HEART WAY
Second Line :
City : MONTGOMERY
State : NY
Zip : 12549-1634
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7 PURPLE HEART WAY
Second Line :
City : MONTGOMERY
State : NY
Zip : 12549-1634
Country : US
Telephone Number : 845-863-7527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2024
Last Update Date : 12/19/2024

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Directions to “ STEPHEN GAMMA ” Practice Location

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