Gustafson, Gregory

Gustafson, Gregory is an individual health care provider with primary practice located at 4401 Francis Lewis Blvd , Bayside NY 11361-3002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Gustafson, Gregory can be contacted via phone (718) 423-3355.

Contact Information

Primary practice address
4401 Francis Lewis Blvd Bayside NY 11361-3002
Phone: (718) 423-3355
Fax: (718) 423-3721
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 138877 New York

Profile Details

NPI number 1629077284
LBN Legal business name Gustafson, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated May 3rd, 2011 - about 14 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 1629077284 NPPES
New York MEDICAID 00827358

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