National Provider Identifier

Gary James Iacobucci, PHD, MD

Gary James Iacobucci, PHD, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 898-4221.

NPI 1922794627Buffalo, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1922794627
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
April 14, 2023
Last Updated
April 14, 2023

Practice Location

  • 462 Grider St
  • Buffalo, NY 14215-3098

Phone: (716) 898-4221

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1922794627
Entity Type
Individual
Last Name
Iacobucci
First Name
Gary
Middle Name
James
Credential
PHD, MD
Mailing Street Address
462 Grider St
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14215-3098
Mailing Country
US
Mailing Phone
(716) 898-4221
Practice Street Address
462 Grider St
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14215-3098
Practice Country
US
Practice Phone
(716) 898-4221
Enumeration Date
April 14, 2023
Last Updated
April 14, 2023
Sex
Male
Sole Proprietor
No
Certification Date
April 14, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)