National Provider Identifier
Kevin N. O'Gorman, M.D.
Kevin N. O'Gorman, M.D. is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Eden, NY and a listed phone number of (716) 992-4999.
Profile Overview
- NPI
- 1083677231
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- April 10, 2006
- Last Updated
- July 08, 2007
Practice Location
- 8600 Depot St
- Eden, NY 14057-1343
Phone: (716) 992-4999
Specialties
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1083677231
- Entity Type
- Individual
- Last Name
- O'Gorman
- First Name
- Kevin
- Middle Name
- N.
- Name Prefix
- Dr.
- Credential
- M.D.
- Provider Other Last Name
- O'Gorman
- Provider Other First Name
- Kevin
- Provider Other Middle Name
- N.
- Provider Other Name Prefix Text
- Dr.
- Provider Other Credential Text
- M.D.
- Provider Other Last Name Type Code
- 2
- Mailing Street Address
- 8600 Depot St
- Mailing City
- Eden
- Mailing State
- NY
- Mailing ZIP Code
- 14057-1343
- Mailing Country
- US
- Mailing Phone
- (716) 992-4999
- Mailing Fax
- (716) 992-9132
- Practice Street Address
- 8600 Depot St
- Practice City
- Eden
- Practice State
- NY
- Practice ZIP Code
- 14057-1343
- Practice Country
- US
- Practice Phone
- (716) 992-4999
- Practice Fax
- (716) 992-9132
- Enumeration Date
- April 10, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 00010352901 (NY, Univera Healthcare), 00699409 (NY), 0401559 (NY, Independent Health), 000508426001 (NY, Bc/Bs Of Wny)