Provider Demographics
NPI:1275586257
Name:GILMORE, JENNIFER N (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:N
Last Name:GILMORE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:N
Other - Last Name:ALOIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:253 FRENCH LEA RD
Mailing Address - Street 2:LEFT
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1648
Mailing Address - Country:US
Mailing Address - Phone:716-536-3555
Mailing Address - Fax:
Practice Address - Street 1:50 E NORTH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1002
Practice Address - Country:US
Practice Address - Phone:716-885-8318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022401225100000X
CA26310225100000X
FL24234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist