Provider Demographics
NPI:1598768970
Name:YORK, GARY L (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:L
Last Name:YORK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 DOLLY RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:NH
Mailing Address - Zip Code:03229-2521
Mailing Address - Country:US
Mailing Address - Phone:603-224-5220
Mailing Address - Fax:603-224-3336
Practice Address - Street 1:194 PLEASANT ST
Practice Address - Street 2:STE 5
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2952
Practice Address - Country:US
Practice Address - Phone:603-224-5220
Practice Address - Fax:603-224-3336
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8086207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH22019661OtherMEDICARE TRAVELERS
NH0108070Y0NH01OtherBLUECROSS/BLUE SHIELD
NH80000156NMedicaid
MHRE0156Medicare ID - Type Unspecified
NH80000156NMedicaid