Individual
CUPID C GASCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
Mailing address
3318 OAK BROOK RD, BALDWINSVILLE, NY 13027-3608
(443) 465-4740
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
205808-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01920805
—
NY
01
—
1144204488
BCBS NY EXCELLUS
NY
05
—
1144204488
—
NY
05
—
404106200
—
MD
Enumeration date
11/30/2005
Last updated
12/03/2009
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