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General NPI Number Information
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NPI Number | 1336406057
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Entity Type | Organization
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Legal Business Name | QUALITY HEALTH FAMILY MEDICAL CARE PC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 145 E. MERRICK ROAD
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City | VALLEY STREAM
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State | NY
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Zip | 11580
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Country | US
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Telephone | 718-801-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 9 DUNSTER ROAD
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 718-801-1627
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MR. JULY GAYSYNSKY
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Credential | MD
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Telephone | 718-801-1627
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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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