MEDICARE: BELA GERSHGORIN

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	104100000X	Social Worker	R074056-1	NY
2	1041C0700X	Clinical Social Worker	R074056-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	G300133806	OTHER	NY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235295544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELA GERSHGORIN

Provider Business Mailing Address
First Line	:	1180 E BROADWAY APT 11
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-2435
Country	:	US
Telephone Number	:	718-753-7227
Fax Number	:

Provider Business Practice Location Address
First Line	:	1612 CENTRAL AVE
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4002
Country	:	US
Telephone Number	:	718-753-7227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	09/29/2025

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Directions to “ BELA GERSHGORIN ” Practice Location

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