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Individual
MR. GARY C WYSOCKI
Active
Individual
MR. GARY C WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008186
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027974001
UNIVERA HEALTH
NY
01
—
00057036602
BLUE CROSS BLUE SHIELD HEALTH NOW
NY
01
—
070515000056
FIDELIS
NY
01
—
9514132
INDEPENDENT HEALTH
NY
Enumeration date
05/15/2006
Last updated
02/17/2022
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