Provider Demographics
NPI:1235154964
Name:GADEN, JAMES FRANCIS (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANCIS
Last Name:GADEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 ROOSEVELT HWY
Mailing Address - Street 2:
Mailing Address - City:KENDALL
Mailing Address - State:NY
Mailing Address - Zip Code:14476-9748
Mailing Address - Country:US
Mailing Address - Phone:585-659-2455
Mailing Address - Fax:585-659-2494
Practice Address - Street 1:16815 ROOSEVELT HWY
Practice Address - Street 2:
Practice Address - City:KENDALL
Practice Address - State:NY
Practice Address - Zip Code:14476-9748
Practice Address - Country:US
Practice Address - Phone:585-659-2455
Practice Address - Fax:585-659-2494
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA1173OtherMEDICARE
NY01480859Medicaid
NY01480859Medicaid