MARY F GANNON PA - NPI 1225014541 - Physician Assistant in Buffalo, NY

Q: What is Mary Gannon's NPI number?

The NPI number for Mary Gannon is 1225014541. It was assigned to this individual provider in the NPPES registry on December 19, 2005.

Q: What is Mary Gannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Mary Gannon was last updated on October 25, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mary F Gannon Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY F GANNON PA (NPI 1225014541) is an individual medical provider in Buffalo, New York, licensed in New York (008638-1) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1225014541

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMARY F GANNONCredential: PA

Location AddressELM AND CARLTON STBuffalo, NY 14263-0001

Mailing AddressElm And Carlton StBuffalo, NY 14263-0001 · (716) 845-2300 · Fax (716) 845-8818

Phone(716) 845-2300

Fax(716) 845-8818

Sole ProprietorNo

Enumeration DateDecember 19, 2005

Last NPPES UpdateOctober 25, 2013

✔ NPI 1225014541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NY · 008638-1

ELM AND CARLTON ST, Buffalo, NY 14263

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Other Identifiers 2

Medicare ID-Type UnspecifiedPA1018NY

Medicare UPINP15031NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE DOYLE MCCARTHY PA

Physician Assistant