Provider Demographics
NPI:1114555224
Name:GAFFNEY, KERRY ANN
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:ANN
Last Name:GAFFNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1859
Mailing Address - Country:US
Mailing Address - Phone:165-572-0123
Mailing Address - Fax:
Practice Address - Street 1:177 BAITING HOLLOW LN
Practice Address - Street 2:
Practice Address - City:BAITING HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:11933-1405
Practice Address - Country:US
Practice Address - Phone:631-603-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334535208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery