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Individual

GUST P VERLENI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
890 E SECOND ST, JAMESTOWN, NY 14701
(716) 661-1583
Mailing address
880 E SECOND ST, JAMESTOWN, NY 14701
(716) 661-1583

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006801
NY
363AM0700X
Medical Physician Assistant
Primary
006801
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02341977
NY
Enumeration date
10/31/2005
Last updated
06/17/2008
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