Provider Demographics
NPI:1851728059
Name:GEHR, KEVIN J (MS, PAC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:J
Last Name:GEHR
Suffix:
Gender:M
Credentials:MS, PAC
Other - Prefix:
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Mailing Address - Street 1:1903 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5617
Mailing Address - Country:US
Mailing Address - Phone:316-624-8150
Mailing Address - Fax:315-797-1537
Practice Address - Street 1:83 GENESEE ST
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2472
Practice Address - Country:US
Practice Address - Phone:315-792-7629
Practice Address - Fax:315-266-1326
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY017043-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400116180Medicare PIN