Provider Demographics
NPI:1154314276
Name:POSTER, GARY D (DPM)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:POSTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PINE ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3502
Mailing Address - Country:US
Mailing Address - Phone:518-792-3032
Mailing Address - Fax:518-792-5051
Practice Address - Street 1:11 PINE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3502
Practice Address - Country:US
Practice Address - Phone:518-792-3032
Practice Address - Fax:518-792-5051
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002919-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00457209Medicaid
NY1305030001Medicare NSC
NY00457209Medicaid
NY37142BMedicare ID - Type UnspecifiedMEDICARE