MEDICARE: GATES MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1104791896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATES MEDICINE PC

Provider Business Mailing Address
First Line	:	8 FAIRFIELD RD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11024-1436
Country	:	US
Telephone Number	:	917-940-3016
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 GATES AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-6488
Country	:	US
Telephone Number	:	917-940-3016
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AFSHIN SHAHKOOHI
Credential	:	MD
Telephone Number	:	917-940-3016

Provider Enumeration Date	:	10/10/2025
Last Update Date	:	01/16/2026

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Directions to “GATES MEDICINE PC ” Practice Location

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