Provider Demographics
NPI:1558768556
Name:GAWRONSKI, MARCI
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:GAWRONSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 ATHENS BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1602
Mailing Address - Country:US
Mailing Address - Phone:716-380-2306
Mailing Address - Fax:
Practice Address - Street 1:174 ATHENS BLVD.
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223
Practice Address - Country:US
Practice Address - Phone:716-380-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist