Basic Information
Provider Information
NPI: 1235196544
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOKOE
FirstName: GAIL
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Practice Location
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Other Information
ProviderEnumerationDate: 04/28/2006
LastUpdateDate: 12/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X209600NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
0002569010201 UNIVERAOTHER
00092039901301 BLUE SHIELD WNYOTHER
106060FF01 PREFERRED CAREOTHER
04042600307901 FIDELISOTHER
P01020960001 BLUE CHOICEOTHER
00092039901001 BLUE SHIELD WNYOTHER
P0001976301 RR MEDICAREOTHER
P0005043801 RR MEDICAREOTHER
P02020960001 BLUE SHIELD ROCHESTEROTHER
0002569010501 UNIVERAOTHER
2096006B01NYWORKERS COMPENSATIONOTHER
419493501 GHIOTHER
0209174305NY MEDICAID
169315501 INDEPENDENT HEALTHOTHER


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