Healthcare Provider Details

I. General information

NPI: 1104010941
Provider Name (Legal Business Name): GYN LAPAROSCOPIC ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 SPRING ST
NEW YORK NY
10012-3645
US

IV. Provider business mailing address

52 E END AVE #10A
NEW YORK NY
10028-7954
US

V. Phone/Fax

Practice location:
  • Phone: 212-717-6040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE ORBUCH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-343-3040