Individual
MR. KEITH GORMAN GRUCHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6301 INDUCON DR E, SANBORN, NY 14132-9014
(716) 731-2030
Mailing address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 831-1800
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
454889-1
NY
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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