Provider Demographics
NPI:1790234490
Name:DOWNING, GARY (MED)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:DOWNING
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 BOYER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-1710
Mailing Address - Country:US
Mailing Address - Phone:215-353-8501
Mailing Address - Fax:610-688-8632
Practice Address - Street 1:5702 BOYER ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138
Practice Address - Country:US
Practice Address - Phone:215-353-8501
Practice Address - Fax:610-688-8632
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health