Gorum, Wendell Joseph

Gorum, Wendell Joseph is an sole proprietor health care provider with primary practice located at 1503 Gravesend Neck Rd , Brooklyn NY 11229-4428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gorum, Wendell Joseph can be contacted via phone (718) 479-3303.

Contact Information

Primary practice address
1503 Gravesend Neck Rd Brooklyn NY 11229-4428
Fax: (646) 569-6993
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 248330 New York

Profile Details

NPI number 1659379469
LBN Legal business name Gorum, Wendell Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2005
Last updated Apr 19th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659379469 NPPES
New York MEDICAID 03078360

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