Basic Information
| Provider Information | |||||||||
| NPI: | 1609295476 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA-RYAN | ||||||||
| FirstName: | GABRIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 593 BOOS LAW RD | ||||||||
| Address2: | |||||||||
| City: | SMYRNA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134642316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312416637 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 GUTHRIE DR | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148303696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6079377200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 289203 | NY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | OS018585 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 289204 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.