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Individual

JERALD GILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 626-5316
Mailing address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 626-5316

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
096757
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010063701
UNIVERA
NY
01
000505237001
BLUE CROSS OF WNY
NY
05
00645616
NY
01
152308BT
PREFERRED CARE
NY
01
2301493
INDEPENDENT HEALTH
NY
01
5330097
AERNA
NY
Enumeration date
12/21/2005
Last updated
10/02/2007
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