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General NPI Number Information
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NPI Number | 1558503219
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Entity Type | Individual
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Provider Name | GAGANDEEP GILL MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 205 N. BELLE MEADE RD. STONY BROOK INTERNAL MEDICINE
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City | E. SETAUKET
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State | NY
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Zip | 11733
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Country | US
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Telephone | 631-444-4630
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Fax | 631-444-4617
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Provider Business Mailing Address
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Address Line | 45 RESEARCH WAY SUITE 204 STONY BROOK ADMINISTRATIVE SERVICES LLC
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City | EAST SETAUKET
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State | NY
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Zip | 11733
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Country | US
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Telephone | 631-615-8279
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 270751
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License Number State | NY
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