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General NPI Number Information
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NPI Number | 1104791896
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Entity Type | Organization
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Legal Business Name | GATES MEDICINE PC
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 420 GATES AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-6488
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Country | US
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Telephone | 917-940-3016
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Fax |
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Provider Business Mailing Address
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Address Line | 8 FAIRFIELD RD
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City | GREAT NECK
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State | NY
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Zip | 11024-1436
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Country | US
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Telephone | 917-940-3016
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AFSHIN SHAHKOOHI
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Credential | MD
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Telephone | 917-940-3016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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