Provider Demographics
NPI:1902292733
Name:GONKA-GRIFFO, JACQUELYN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:MARIE
Last Name:GONKA-GRIFFO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3085 HARLEM RD STE 350
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2591
Mailing Address - Country:US
Mailing Address - Phone:716-844-5600
Mailing Address - Fax:716-844-5750
Practice Address - Street 1:3085 HARLEM RD STE 200
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2591
Practice Address - Country:US
Practice Address - Phone:716-844-5000
Practice Address - Fax:716-844-5750
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2021-08-17
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Provider Licenses
StateLicense IDTaxonomies
NY3094542088F0040X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery