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NPI Code Detail

MEDICARE: SHINE MEDICAL PC

MEDICARE: SHINE MEDICAL PC
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
1208000000XPediatrics Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1811942782
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHINE MEDICAL PC
Provider Business Mailing Address
First Line : 6860 AUSTIN ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4224
Country : US
Telephone Number : 718-896-0999
Fax Number : 718-896-8502
Provider Business Practice Location Address
First Line : 6860 AUSTIN ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4220
Country : US
Telephone Number : 718-896-0999
Fax Number : 718-896-8502
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. SERGEY GABINSKY
Credential : M.D.
Telephone Number : 718-896-0999
Provider Enumeration Date : 05/22/2006
Last Update Date : 09/11/2025

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Directions to “SHINE MEDICAL PC ” Practice Location

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