Individual
TARA L GELLASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 DRIVING PARK AVE, NEWARK, NY 14513-1057
(315) 332-2427
(315) 332-2324
Mailing address
1250 DRIVING PARK AVE, NEWARK, NY 14513-1057
(315) 332-2427
(315) 332-2324
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101237926
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
253197
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03105295
—
NY
Enumeration date
08/08/2006
Last updated
01/09/2014
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