Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 14516 | NH |
N | 207QS0010X | Family Doctor - Sports Medicine | 14516 | NH |
Y | 207QS0010X | Family Doctor - Sports Medicine | 276638 | NY |
NPI | 1265429179 |
---|---|
Provider Name | Dr. Gabriel C Lurvey |
First Address | Auburn, NY 13021-1945 |
Second Address | Auburn, NY 13021-1931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 29/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04155139 | (05) | NY |