MEDICARE: GABOR MENCZELESZ MD 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	207R00000X	Internal Medicine Physician	210461	NY

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	:	1740420561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GABOR MENCZELESZ MD PC

Provider Business Mailing Address
First Line	:	2563 E 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6201
Country	:	US
Telephone Number	:	718-368-1666
Fax Number	:

Provider Business Practice Location Address
First Line	:	3049 OCEAN PKWY
Second Line	:	2 ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8372
Country	:	US
Telephone Number	:	718-368-1666
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. GABOR MENCZELESZ
Credential	:	M.D.
Telephone Number	:	718-368-1666

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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