MEDICARE: GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C.

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	053186	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1710246533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C.

Provider Business Mailing Address
First Line	:	563 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-4655
Country	:	US
Telephone Number	:	718-466-4500
Fax Number	:	917-792-8502

Provider Business Practice Location Address
First Line	:	563 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-4655
Country	:	US
Telephone Number	:	718-466-4500
Fax Number	:	917-792-8502

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELEFTHERIOS GAVRIIL
Credential	:	DDS
Telephone Number	:	718-466-4500

Provider Enumeration Date	:	05/14/2012
Last Update Date	:	05/14/2012

Similar Medicare Providers

1093947673 — MR. GANESH INAPAKOLLA PHARMAIST
Practice Location Address:

563 E TREMONT AVE
BRONX, NY
10457-4655

Practice Phone: 718-466-4700
Practice Fax:

1629395389 — BEST AID COMMUNITY PHARMACY LLC
Practice Location Address:

563 E TREMONT AVE # 573
BRONX, NY
10457-4655

Practice Phone: 718-466-4700
Practice Fax: 718-466-4704

1306112560 — ZEN DENTAL P.C.
Practice Location Address:

563 E TREMONT AVE
BRONX, NY
10457-4655

Practice Phone: 845-527-7772
Practice Fax:

1942569538 — TREMONT MEDICAL SERVICES , P.C.
Practice Location Address:

563 E TREMONT AVE
BRONX, NY
10457-4655

Practice Phone: 718-466-4500
Practice Fax: 917-792-8502

1336652593 — TREMONT SMILES DENTAL PC
Practice Location Address:

563 E TREMONT AVE
BRONX, NY
10457-4655

Practice Phone: 718-466-4500
Practice Fax: 917-792-8502

1205460581 — TREMONT HELPS INC
Practice Location Address:

563 E TREMONT AVE FRNT 2
BRONX, NY
10457-4655

Practice Phone: 917-345-6801
Practice Fax:

Directions to “GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.