Individual
MRS. DOROTHY RUTH GANSCHOW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3495 BAILEY AVE, BUFFALO, NY 14215-1129
(716) 862-8757
(716) 862-3298
Mailing address
6100 EASTWOOD RD, CLARENCE CENTER, NY 14032-9653
(716) 741-4603
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007864
NY
Other
Enumeration date
12/14/2005
Last updated
07/09/2007
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