Organization
JULIE A GAVIN MD OBGYN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A GAVIN MD (OWNER)
(716) 913-2297
Entity
Organization
Contact information
Practice address
3800 DELAWARE AVE, KENMORE, NY 14217-1094
(716) 913-2297
Mailing address
908 NIAGARA FALLS BLVD, STE 208, N TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 332-3525
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
243652
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02893401
—
NY
01
—
0714301
IHA
NY
Enumeration date
03/17/2011
Last updated
03/17/2011
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