Healthcare Provider Details

I. General information

NPI: 1629577804
Provider Name (Legal Business Name): PERINATAL DIAGNOSTIC CENTERS OF NEW YORK & NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 LILY POND AVE
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: 201-608-0497
Mailing address:
  • Phone: 833-732-1131
  • Fax: 201-608-0497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number2844091
License Number StateNY

VIII. Authorized Official

Name: DR. GEORGE F GUIRGUIS
Title or Position: PRESIDENT
Credential: DO, FACOG, MFM
Phone: 929-754-1667