Healthcare Provider Details

I. General information

NPI: 1154706471
Provider Name (Legal Business Name): GILANI MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 5TH AVE STE A
BROOKLYN NY
11220-3853
US

IV. Provider business mailing address

5721 5TH AVE STE A
BROOKLYN NY
11220-3853
US

V. Phone/Fax

Practice location:
  • Phone: 718-439-1114
  • Fax:
Mailing address:
  • Phone: 718-439-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number185171
License Number StateNY

VIII. Authorized Official

Name: TAJAMMAL GILANI
Title or Position: PRESIDENT
Credential: MD
Phone: 718-439-1114