Individual
DR. JOHN RICHARD GAVENCAK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 ATLANTIC AVE, EAST ROCKAWAY, NY 11518-1433
(516) 599-2732
(516) 593-2075
Mailing address
400 ATLANTIC AVE, EAST ROCKAWAY, NY 11518-1433
(516) 599-2732
(516) 593-2075
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
124874
NY
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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