Individual
JENNIFER GURSKE-DEPERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5959 BIG TREE RD, ORCHARD PARK, NY 14127-2291
(716) 821-4400
(716) 829-2138
Mailing address
4225 GENESEE ST, SUITE 107, CHEEKTOWAGA, NY 14225-1994
(716) 906-5908
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
251338
NY
207X00000X
Orthopaedic Surgery Physician
ME106411
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251338
LICENSE NUMBER, STATE OF NEW YORK
NY
01
—
390200000X
STUDENT, HEALTH CARE
NY
Enumeration date
07/28/2008
Last updated
12/06/2016
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