Individual
MARY F GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-2300
(716) 845-8818
Mailing address
ELM AND CARLTON ST, BUFFALO, NY 14263-0001
(716) 845-2300
(716) 845-8818
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008638-1
NY
Other
Enumeration date
12/19/2005
Last updated
10/25/2013
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