# GJKS PHYSICIAN, PC

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

## Provider details

- **NPI number:** 1609583228
- **Authorized official:** KAITLYNN LESTER (PRACTICE MANAGER)
- **Authorized official phone:** (716) 236-7880

## Contact information

- **Practice address:** 4515 MILITARY RD, NIAGARA FALLS, NY 14305-1335
- **Practice address phone:** (716) 236-7880
- **Practice address fax:** (716) 236-7885
- **Mailing address:** 4515 MILITARY RD, NIAGARA FALLS, NY 14305-1335
- **Mailing address phone:** (716) 236-7880
- **Mailing address fax:** (716) 236-7885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/02/2022
- **Last updated:** 07/06/2023