Jayakumari Gona, MD
Individual provider Active NPI Nuclear Imaging & Therapy Physician · Locport, NY
NPI 1922064799 · NPPES record last updated Nov 29, 2010
Key facts
- NPI
- 1922064799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nuclear Imaging & Therapy Physician 207UN0902X
- License
- 135032 (NY)
- Practice address
- 64 Davison CT
Locport, NY 14094 - Phone
- (716) 433-3572
- Fax
- (716) 829-2348
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suny Buffalo | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Imaging & Therapy Physician | 207UN0902X | 135032 | NY | Yes |
Addresses
Primary practice location
64 Davison CT
Locport, NY 14094
Mailing address
3435 Main St 105 Parker Hall #10
Buffalo, NY 14214
Phone (716) 834-8194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01789582 | Medicaid | NY |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.