Basic Information
Provider Information
NPI: 1225095003
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAIS
FirstName: DAWN
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 425 ESSJAY RD STE 170
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142218235
CountryCode: US
TelephoneNumber: 7166301219
FaxNumber: 7168171726
Practice Location
Address1: 2741 TRANSIT RD
Address2:  
City: ELMA
State: NY
PostalCode: 140599634
CountryCode: US
TelephoneNumber: 7166776060
FaxNumber: 7166776078
Other Information
ProviderEnumerationDate: 04/27/2006
LastUpdateDate: 06/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X187958-2NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
0001005940301NYUNIVERAOTHER
0203924705NY MEDICAID
040602601NYIHAOTHER
16100058001NYEMPIREOTHER
16100058001NYNOVAOTHER
00052326800401NYHEALTH NOWOTHER
16100058001NYNORTH AMERICAN PREFERREDOTHER
11019943901NYRR MEDICAREOTHER


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