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NPI Code Detail

MEDICARE: DR. GAUDENCIO ARRUEJO M.D.

MEDICARE: DR. GAUDENCIO ARRUEJO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician123009NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548266141
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GAUDENCIO ARRUEJO M.D.
Provider Business Mailing Address
First Line : 66 POWERHOUSE RD
Second Line : FL 3
City : ROSLYN HTS
State : NY
Zip : 11577-1324
Country : US
Telephone Number : 516-626-6366
Fax Number :
Provider Business Practice Location Address
First Line : 5115 BEACH CHANNEL DR
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1042
Country : US
Telephone Number : 718-734-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/08/2007

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