Provider Demographics
NPI:1366641656
Name:GULLO, FRANK JOSEPH (BSW,CASAC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JOSEPH
Last Name:GULLO
Suffix:
Gender:M
Credentials:BSW,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GOODRICH ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1005
Mailing Address - Country:US
Mailing Address - Phone:716-859-2133
Mailing Address - Fax:716-859-2560
Practice Address - Street 1:80 GOODRICH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1005
Practice Address - Country:US
Practice Address - Phone:716-859-2133
Practice Address - Fax:716-859-2560
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health