Provider Demographics
NPI:1609905819
Name:G&P GYNECARE PC
Entity Type:Organization
Organization Name:G&P GYNECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VACANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-366-4210
Mailing Address - Street 1:306 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2125
Mailing Address - Country:US
Mailing Address - Phone:716-366-4210
Mailing Address - Fax:716-366-3549
Practice Address - Street 1:306 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2125
Practice Address - Country:US
Practice Address - Phone:716-366-4210
Practice Address - Fax:716-366-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00865247Medicaid
NY0200489OtherGHI
NYY019094OtherCHAMPUS
NY000000081723OtherGHI HMO
NY01197002Medicaid
NY9512292OtherINDEPENDENT HEALTH
NY00500746OtherBLUE CROSS BLUE SHIELD
NY9512254OtherINDEPENDENT HEALTH
NY0296715OtherGHI PPO
NY0703196OtherINDEPENDENT HEALTH
NY0001013710OtherUNIVERA
NY040426003767OtherFIDELIS
NY53221AMedicare ID - Type UnspecifiedMEDICARE
NYB82646Medicare UPIN
NY53221DMedicare ID - Type UnspecifiedMEDICARE
NY53221BMedicare ID - Type UnspecifiedMEDICARE