Organization
EDEN PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIGID O'GORMAN MD (OWNER)
(716) 575-7282
Entity
Organization
Contact information
Practice address
8274 N MAIN ST, EDEN, NY 14057-1104
(716) 725-8114
Mailing address
8274 N MAIN ST, EDEN, NY 14057-1104
(716) 575-7282
(716) 899-5081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301295
NYS MEDICAL LICENSE
NY
Enumeration date
03/25/2022
Last updated
04/01/2026
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