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General NPI Number Information
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NPI Number | 1639678428
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Entity Type | Organization
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Legal Business Name | GRAMERCY MEDICAL SERVICES P.C.
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 11/22/2018
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Provider Practice Location Address
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Address Line | 13916 91ST AVE
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City | JAMAICA
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State | NY
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Zip | 11435-4219
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Country | US
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Telephone | 917-854-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 13916 91ST AVE
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City | JAMAICA
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State | NY
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Zip | 11435-4219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/INCORPORATOR
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Name | DR. MICHELLE ROTBLAT-OPERMAN
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Credential | MD
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Telephone | 718-989-5550
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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 | 251283
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License Number State | NY
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