Basic Information
Provider Information
NPI: 1902083116
EntityType: 2
ReplacementNPI:  
OrganizationName: DEBORAH GAHR MD PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: SOHO OBGYN
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2003
Address2:  
City: EAST SYRACUSE
State: NY
PostalCode: 130574503
CountryCode: US
TelephoneNumber: 3154463904
FaxNumber: 3154452936
Practice Location
Address1: 430 W BROADWAY
Address2: 2ND FLOOR
City: NEW YORK
State: NY
PostalCode: 100123784
CountryCode: US
TelephoneNumber: 2129410011
FaxNumber: 2129415977
Other Information
ProviderEnumerationDate: 01/30/2008
LastUpdateDate: 01/30/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GAHR
AuthorizedOfficialFirstName: DEBORAH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2129410011
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VG0400X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

No ID Information.


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