Healthcare Provider Details

I. General information

NPI: 1366529976
Provider Name (Legal Business Name): NYMIS MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 E 14TH ST SUITE 2
BROOKLYN NY
11230-7148
US

IV. Provider business mailing address

1502 E 14TH ST SUITE 2
BROOKLYN NY
11230-7148
US

V. Phone/Fax

Practice location:
  • Phone: 718-645-6304
  • Fax:
Mailing address:
  • Phone: 718-645-6304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY PISKUN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-645-6304