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:
Health care specialties
Specialty | Code | License # | 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 13 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1629077284 | NPPES |
New York | MEDICAID | 00827358 |
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