MEDICARE: DENNIS GAHAGEN

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	183500000X	Pharmacist	032183	NY

General Provider Information

NPI Number	:	1992028815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS GAHAGEN

Provider Business Mailing Address
First Line	:	1717 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-1209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14223-1209
Country	:	US
Telephone Number	:	716-875-4131
Fax Number	:	716-875-4617

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

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	03/05/2010

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Directions to “ DENNIS GAHAGEN ” Practice Location

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