Individual
MR. CONOR GALLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
425 ESSJAY RD STE 180, WILLIAMSVILLE, NY 14221-5782
(716) 630-1140
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8235
(716) 630-1219
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/30/2018
Last updated
12/13/2021
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