Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X03219-1 | NY |
NPI | 1518052505 |
---|---|
Provider Name | Dr. Geoffrey John Gerow |
First Address | Buffalo, NY 14208-1602 |
Second Address | Buffalo, NY 14208-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 04/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16137088501 | UNIVERA (PRISM HEALTH NET (01) | NY |
2256355 | BLUE CROSS/BLUE SHIELD (01) | NY |
8809931 | INDEPENDENT HEALTH (01) | NY |
C03219-5B | WORKERS COMPENSATION (01) | NY |
T38248 | (02) | NY |