Healthcare Provider Details

I. General information

NPI: 1407087711
Provider Name (Legal Business Name): GEORGE GUIRGUIS DO, FACOG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 LILY POND AVE FL 2
STATEN ISLAND NY
10305-4608
US

IV. Provider business mailing address

174 LILY POND AVE FL 2
STATEN ISLAND NY
10305-4608
US

V. Phone/Fax

Practice location:
  • Phone: 833-732-1131
  • Fax:
Mailing address:
  • Phone: 929-754-1667
  • Fax: 201-608-0497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number284409
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number02006092B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: