Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 3641-1 | NY |
NPI | 1093726952 |
---|---|
Provider Name | Maurice M Gelia |
First Address | Tonawanda, NY 14150-2935 |
Second Address | Tonawanda, NY 14150-2935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 11/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01113157 | (05) | NY |
1093726952 | NATIONAL PROVIDER IDENTIFIER (01) | NY |
480004594 | MEDICARE RAILROAD (01) | NY |
T88262 | (02) | NY |