Healthcare Provider Details

I. General information

NPI: 1235750985
Provider Name (Legal Business Name): GREGORY VURTURE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PL
BRONX NY
10461-2720
US

IV. Provider business mailing address

2664 WINDSOR AVE
OCEANSIDE NY
11572-1145
US

V. Phone/Fax

Practice location:
  • Phone: 718-944-3838
  • Fax:
Mailing address:
  • Phone: 516-764-1413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number328478
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: