Provider Demographics
NPI:1487604955
Name:GENTILE, JOSEPH DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DONALD
Last Name:GENTILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4239 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1039
Mailing Address - Country:US
Mailing Address - Phone:716-832-9747
Mailing Address - Fax:716-835-1470
Practice Address - Street 1:4239 MAPLE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1039
Practice Address - Country:US
Practice Address - Phone:716-832-9747
Practice Address - Fax:716-835-1470
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY109612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC49516Medicare UPIN