=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073791927
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GN PHYSICIANS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2008
-----------------------------------------------------
Last Update Date | 04/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 NORTHERN BLVD SUITE# 3B
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021-5314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-423-2429
-----------------------------------------------------
Fax | 917-386-2691
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 NORTHERN BLVD SUITE# 3B
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021-5314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-423-2429
-----------------------------------------------------
Fax | 917-386-2691
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. TOM HOPKINS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 516-423-2429
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | 222663
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------