Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 34-008985 | OH |
NPI | 1003006727 |
---|---|
Provider Name | Katherine Anne Gambacorta |
First Address | Clarence, NY 14031-1589 |
Second Address | Williamsville, NY 14221-6728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 11/01/2021 |