Healthcare Provider Details

I. General information

NPI: 1033124847
Provider Name (Legal Business Name): GREGORY GIRSHIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 11/07/2024
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LINCOLN MEDICAL AND MENTAL HEALTH CENTER 234 E 149 STREET
BRONX NY
10451
US

IV. Provider business mailing address

800 WOLFS LANE
PELHAM NY
10803
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5717
  • Fax: 212-939-2759
Mailing address:
  • Phone: 914-522-9039
  • Fax: 212-939-2759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number000686
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number252425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: