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General NPI Number Information
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NPI Number | 1619166097
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Entity Type | Organization
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Legal Business Name | GPDDC, LLC
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 250 PARK AVE S 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10003-1402
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Country | US
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Telephone | 212-979-3237
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PARK AVE S FL 8
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City | NEW YORK
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State | NY
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Zip | 10003-1402
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Country | US
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Telephone | 212-979-3237
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Fax | 212-979-3447
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | NY
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