Provider Demographics
NPI:1063470003
Name:MCGORRAY, MARY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:MCGORRAY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-857-8944
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1159
Practice Address - Fax:716-250-5950
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY192032-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000523035004OtherHEALTH NOW
NY110170246OtherRR MEDICARE
NY00010114501OtherUNIVERA
NY01481938Medicaid
NY0405585OtherIHA
NY161000580OtherEMPIRE
NY161000580OtherNOVA
NY161000580OtherNORTH AMERICAN PREFERRED
NY161000580OtherAETNA
NY192032-1WOtherWORKERS COMPENATION
NY192032-1WOtherWORKERS COMPENATION
NY161000580OtherNORTH AMERICAN PREFERRED