Individual provider Active NPI

Gary J Dunner, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1679638944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R026113-1 Issued in NY
Practice address
2105 W Genesee St
Suite 113
Syracuse, NY 13219-1656
Phone
(315) 488-1884
Fax
(315) 488-1884
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R026113-1 NY Primary

Addresses

Primary practice location

2105 W Genesee St
Suite 113
Syracuse, NY 13219-1656

Mailing address

2105 W Genesee St
Suite 113
Syracuse, NY 13219-1656
Phone (315) 488-1884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140423001398 NY Practitioner - Clinical Social Worker 5496988693 Practice locations: Syracuse, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2105 W Genesee St
Suite 113
Syracuse, NY 13219-1676
Phone (315) 488-1884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R026113-1NYMDClinical Social Worker
026113NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679638944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 W GENESEE ST",
            "address_2": "SUITE 113",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191656",
            "telephone_number": "315-488-1884",
            "fax_number": "315-488-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 W GENESEE ST",
            "address_2": "SUITE 113",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191656",
            "telephone_number": "315-488-1884",
            "fax_number": "315-488-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNER",
        "first_name": "GARY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R026113-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.