Healthcare Provider Details

I. General information

NPI: 1013471978
Provider Name (Legal Business Name): GIL MEDICAL SERVICES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 88TH ST
JACKSON HEIGHTS NY
11372-7631
US

IV. Provider business mailing address

3722 88TH ST
JACKSON HEIGHTS NY
11372-7631
US

V. Phone/Fax

Practice location:
  • Phone: 718-507-9878
  • Fax: 718-507-9894
Mailing address:
  • Phone: 718-507-9878
  • Fax: 718-507-9894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GIOVANNY FERNANDO GIL SARES
Title or Position: MEDICAL DIRECTO
Credential: MD
Phone: 718-507-9878