Organization
JERRY J TRACY III, PHYSICIAN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAITLIN GARTLER (OFFICE MANAGER)
(716) 799-5351
Entity
Organization
Contact information
Practice address
1275 MAIN ST, SUITE 110, BUFFALO, NY 14209-1911
(716) 799-5351
(716) 342-2974
Mailing address
1275 MAIN ST, SUITE 110, BUFFALO, NY 14209-1911
(716) 799-5351
(716) 342-2974
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
2250481
NY
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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