Provider Demographics
NPI:1497862213
Name:COLE-HOOVER, GWENDOLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:
Last Name:COLE-HOOVER
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 1:7557 GREENBUSH RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9719
Mailing Address - Country:US
Mailing Address - Phone:585-297-1265
Mailing Address - Fax:
Practice Address - Street 1:222 RICHMOND AVE
Practice Address - Street 2:WESTERN NY VA HEALTH CARE SYSTEMS
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1227
Practice Address - Country:US
Practice Address - Phone:585-297-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine