Individual
GARY NEIL MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 IVY ST, SUITE 201, ELMIRA, NY 14905-1627
(607) 737-7780
(607) 737-7788
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
286574
NY
208600000X
Surgery Physician
MD00038838
WA
208600000X
Surgery Physician
Q5859
TX
2086X0206X
Surgical Oncology Physician
MD00038838
WA
2086X0206X
Surgical Oncology Physician
Q5859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231489
L&I
WA
05
—
04588487
—
NY
05
—
1760567572
—
WA
01
—
265110
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
349029401
—
TX
Enumeration date
10/27/2006
Last updated
02/18/2017
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