National Provider Identifier
Gordon Bolles, NP
Gordon Bolles, NP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Buffalo, NY and a listed phone number of (716) 859-5600.
Profile Overview
- NPI
- 1013538461
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- April 27, 2020
- Last Updated
- January 21, 2021
Practice Location
- 100 High St
- Buffalo, NY 14203-1126
Phone: (716) 859-5600
Mailing Address
- 425 Essjay RD Ste 170
- Williamsville, NY 14221-8235
Specialties
- Nurse Practitioner (363L00000X)
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1013538461
- Entity Type
- Individual
- Last Name
- Bolles
- First Name
- Gordon
- Credential
- NP
- Mailing Street Address
- 425 Essjay RD Ste 170
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-8235
- Mailing Country
- US
- Mailing Phone
- (716) 630-1219
- Practice Street Address
- 100 High St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203-1126
- Practice Country
- US
- Practice Phone
- (716) 859-5600
- Enumeration Date
- April 27, 2020
- Last Updated
- January 21, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- January 21, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X), Adult Health Nurse Practitioner (363LA2200X)