MEDICARE: GSP 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
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	159537-1	NY

General Provider Information

NPI Number	:	1932284114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GSP MEDICAL, PC

Provider Business Mailing Address
First Line	:	3049 OCEAN PKWY
Second Line	:	SUITE 300
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8302
Country	:	US
Telephone Number	:	718-615-3000
Fax Number	:	718-332-2458

Provider Business Practice Location Address
First Line	:	3049 OCEAN PKWY
Second Line	:	SUITE 300
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8302
Country	:	US
Telephone Number	:	718-615-3000
Fax Number	:	718-332-2458

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GRIGORY S. POGREBINSKY
Credential	:	M.D.
Telephone Number	:	718-615-3000

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	06/13/2008

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