Healthcare Provider Details

I. General information

NPI: 1881213239
Provider Name (Legal Business Name): GINA LEE GURSKIY LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

IV. Provider business mailing address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5000
  • Fax:
Mailing address:
  • Phone: 718-670-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number42807
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002700
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: