Healthcare Provider Details

I. General information

NPI: 1730134339
Provider Name (Legal Business Name): GURMIT S GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 STEWART AVE
GARDEN CITY NY
11530-4771
US

IV. Provider business mailing address

623 STEWART AVE
GARDEN CITY NY
11530-4771
US

V. Phone/Fax

Practice location:
  • Phone: 516-741-0055
  • Fax: 516-745-8008
Mailing address:
  • Phone: 516-741-0055
  • Fax: 516-745-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number182198-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number182198-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number182198-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number182198-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: