436 Gwb Medical Office Pc
LBN: 436 Gwb Medical Office Pc
436 Gwb Medical Office Pc is an health care organization with primary practice located at 436 Fort Washington Ave Apt 1A , New York NY 10033-3533. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty.
436 Gwb Medical Office Pc can be contacted via phone (212) 923-0408, or through Goris, Jose A via phone (212) 923-0408.
Contact Information
Primary practice address
436 Fort Washington Ave Apt 1A
New York NY 10033-3533
Phone: (212) 923-0408
Fax: (212) 923-7051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X |
Profile Details
| NPI number | 1366952913 |
|---|---|
| LBN Legal business name | 436 Gwb Medical Office Pc |
| DBA Doing business as | |
| Authorized official | Goris, Jose A Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 10th, 2017 |
| Last updated | Oct 10th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366952913 | NPPES |
| New York | MEDICAID | 01740610 |
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