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General NPI Number Information
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NPI Number | 1558356063
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Entity Type | Individual
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Provider Name | GREGORY H SIROUNIAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 1300 FRANKLIN AVE SUITE UL3A
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City | GARDEN CITY
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State | NY
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Zip | 11530-1886
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Country | US
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Telephone | 516-747-8900
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Fax | 516-663-8166
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Provider Business Mailing Address
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Address Line | PO BOX 9004
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City | PHOENIX
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State | AZ
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Zip | 85068-9004
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Country | US
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Telephone | 623-512-4359
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Fax | 623-512-4364
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 30048
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 261465-1
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License Number State | NY
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