Healthcare Provider Details

I. General information

NPI: 1972498681
Provider Name (Legal Business Name): PERINATAL DIAGNOSTIC ULTRASOUND, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
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

464 77TH ST
BROOKLYN NY
11209-3206
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 Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE GUIRGUIS
Title or Position: PRESIDENT, CEO
Credential: DO, FACOG
Phone: 833-732-1131