Individual
DR. HERMAN S. MOGAVERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 HIGH ST, BUFFALO, NY 14203-1149
(716) 857-8615
(716) 250-5942
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
131152-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010120501
UNIVERA
NY
01
—
000508601001
HELATH NOW
NY
01
—
0021748
GHI
NY
05
—
00721962
—
NY
01
—
0300549
IHA
NY
01
—
070003237
RR MEDICARE
NY
01
—
131152-1W
WORKERS COMPENSATION
NY
01
—
161000580
EMPIRE
NY
Enumeration date
05/01/2006
Last updated
12/06/2021
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