Provider Demographics
NPI:1740257534
Name:GACIOCH, GERALD M (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:M
Last Name:GACIOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 HAGEN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2658
Mailing Address - Country:US
Mailing Address - Phone:585-338-2700
Mailing Address - Fax:585-242-9663
Practice Address - Street 1:30 HAGEN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2658
Practice Address - Country:US
Practice Address - Phone:585-338-2700
Practice Address - Fax:585-242-9663
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160019207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
005242091OtherHEALTHNOW POB
000524209002OtherHEALTH NOW LINDEN
7701220OtherMVP
NY01197584Medicaid
PO10160019OtherEXCELLUS
005242091OtherCOMM BLUE/BCBSWNY
301129OtherWELLCARE
RC60160019OtherRCIPA
0000834851OtherUNITED HEALTHCARE
060012728OtherRAILROAD MEDICARE
4266402OtherAETNA
6890OtherBCBS
P010160019OtherGRIPA
137401527OtherTRICARE/CHAMPUS
MD459LOtherPREFERRED CARE
9682189OtherGHI
RC60160019OtherRCIPA
7701220OtherMVP