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General NPI Number Information
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NPI Number | 1629345426
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Entity Type | Organization
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Legal Business Name | GC ONCOLOGY SERVICES PC
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 120 MINEOLA BLVD SUITE 430
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City | MINEOLA
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State | NY
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Zip | 11501-4064
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Country | US
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Telephone | 516-742-5353
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Fax | 516-742-4207
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Provider Business Mailing Address
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Address Line | 120 MINEOLA BLVD SUITE 430
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City | MINEOLA
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State | NY
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Zip | 11501-4064
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Country | US
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Telephone | 516-742-5353
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Fax | 516-742-4207
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | DR. LEO WIENER
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Credential | MD
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Telephone | 516-742-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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