# GEBHARD MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336229509
- **Authorized official:** ROBERTA E GEBHARD D.O. (OWNER PHYSICIAN)
- **Authorized official phone:** (716) 649-0887

## Contact information

- **Practice address:** 2950 ELMWOOD AVE, KENMORE, NY 14217-1304
- **Practice address phone:** (716) 649-0887
- **Practice address fax:** (716) 646-4611
- **Mailing address:** 40 CARDINAL LN, GRAND ISLAND, NY 14072-1950
- **Mailing address phone:** (716) 649-0887
- **Mailing address fax:** (716) 646-4611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 176365 | NY | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 02/14/2008