Healthcare Provider Details

I. General information

NPI: 1649664830
Provider Name (Legal Business Name): GILLIAN ALICE HOPGOOD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 112TH ST
FOREST HILLS NY
11375-2349
US

IV. Provider business mailing address

6735 112TH ST
FOREST HILLS NY
11375-2349
US

V. Phone/Fax

Practice location:
  • Phone: 718-301-9944
  • Fax:
Mailing address:
  • Phone: 718-301-9944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number294945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: