Provider Demographics
NPI:1013084177
Name:DHALIWAL, GURPREET K (MD)
Entity type:Individual
Prefix:
First Name:GURPREET
Middle Name:K
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-857-8944
Practice Address - Street 1:6245 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4834
Practice Address - Country:US
Practice Address - Phone:716-631-1150
Practice Address - Fax:716-630-1265
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242343207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11303OtherMAGNA CARE/AETNA
NY070807000101OtherFIDELIS
NY000528954002OtherHEALTH NOW
NY0714046OtherINDEPENDENT HEALTH
NY02832837Medicaid
NY00027831001OtherUNIVERA
NY00027831001OtherUNIVERA