Healthcare Provider Details

I. General information

NPI: 1740184662
Provider Name (Legal Business Name): GIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 47TH AVE
SUNNYSIDE NY
11104-4447
US

IV. Provider business mailing address

4470 21ST ST STE 5005
LONG ISLAND CITY NY
11101-5114
US

V. Phone/Fax

Practice location:
  • Phone: 718-673-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARWA ELHASSA
Title or Position: MANAGING MEMBER
Credential:
Phone: 718-673-8100