1235196544 NPI number — DR. GAIL E STOKOE MD

Table of content: DR. GAIL E STOKOE MD (NPI 1235196544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235196544 NPI number — DR. GAIL E STOKOE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOKOE
Provider First Name:
GAIL
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235196544
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 N MAPLEMERE RD STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-3178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-836-4646
Provider Business Mailing Address Fax Number:
716-836-4696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 N MAPLEMERE RD STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-3178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-836-4646
Provider Business Practice Location Address Fax Number:
716-836-4696
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  209600 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000920399013 . This is a "BLUE SHIELD WNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02091743 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 106060FF . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000920399010 . This is a "BLUE SHIELD WNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00025690105 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00025690102 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426003079 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1693155 . This is a "INDEPENDENT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2096006B . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P020209600 . This is a "BLUE SHIELD ROCHESTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00019763 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00050438 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P010209600 . This is a "BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4194935 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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