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Individual

GARY JOHN KOLANCHICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1772 HELDERBERG TRL, BERNE, NY 12023-2709
(518) 872-9258
Mailing address
1772 HELDERBERG TRL, APT 1, BERNE, NY 12023-2709
(518) 872-9262
(518) 872-9265

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
142539
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00714705
NY
01
110623000091
FIDELIS
NY
01
308205
SENIOR WHOLE HEALTH
NY
01
5385308
AETNA
NY
01
651047
GHI/HMO
NY
01
7D0091
EMPIRE BLUECROSS
NY
Enumeration date
11/16/2005
Last updated
07/07/2011
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