Individual
MR. KEITH A GEMBUSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
401 N. 8TH ST., OLEAN, NY 14760
(716) 379-8113
(716) 379-8115
Mailing address
401 N. 8TH ST., OLEAN, NY 14760
(716) 379-8113
(716) 379-8115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
257608
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018787180001
—
NY
Enumeration date
09/04/2007
Last updated
06/28/2023
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