Provider Demographics
NPI:1447202684
Name:GAARY, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GAARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 HUDSON DR STE 210
Mailing Address - Street 2:ARIS RADIOLOGY
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4455
Mailing Address - Country:US
Mailing Address - Phone:330-655-1869
Mailing Address - Fax:330-655-3828
Practice Address - Street 1:5655 HUDSON DR STE 210
Practice Address - Street 2:ARIS RADIOLOGY
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4455
Practice Address - Country:US
Practice Address - Phone:330-655-1869
Practice Address - Fax:330-655-3828
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199828-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02186203OtherMEDICAID GROUP#
NYW35021OtherMEDICARE GROUP#
NY01927875Medicaid
NY1467560854OtherNPI GROUP#
NY02186203OtherMEDICAID GROUP#
NY01927875Medicaid
NYW35021OtherMEDICARE GROUP#
NHRE7915Medicare PIN