Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N004553-1 | NY |
NPI | 1346210028 |
---|---|
Provider Name | Dr. Robert Lee Gilfert |
First Address | Wellsville, NY 14895-9327 |
Second Address | Wellsville, NY 14895-9327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 24/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000510739001 | BLUE CROSS BLUE SHIELD (01) | NY |
01159604 | (05) | NY |
0316540001 | DMERC PTAN (01) | NY |
U02392 | (02) | NY |