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General NPI Number Information
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NPI Number | 1750698197
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Entity Type | Organization
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Legal Business Name | GC MEDICAL P.C.
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 3 BREWSTER ST
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City | GLEN COVE
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State | NY
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Zip | 11542-2510
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Country | US
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Telephone | 516-759-7702
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Fax | 516-674-0572
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Provider Business Mailing Address
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Address Line | 3 BREWSTER ST
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City | GLEN COVE
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State | NY
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Zip | 11542-2510
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Country | US
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Telephone | 516-759-7702
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Fax | 516-674-0572
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Authorized Official
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Title or Position | MANAGER
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Name | MOLLY WALKER
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Credential |
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Telephone | 516-385-1525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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