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General NPI Number Information
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NPI Number | 1154407013
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Entity Type | Organization
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Legal Business Name | DR GREGORY SHIFRIN OBGYN PC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 1766 E 12TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-743-0505
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Fax | 718-339-0760
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Provider Business Mailing Address
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Address Line | 1766 E 12TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 718-743-0505
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Fax | 718-339-0760
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREGORY SHIFRIN
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Credential | M.D.
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Telephone | 718-743-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 202259
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License Number State | NY
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