MEDICARE: DR. GARY S MAGID MD

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	2084P0800X	Psychiatry Physician	240140	NY

General Provider Information

NPI Number	:	1932298767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY S MAGID MD

Provider Business Mailing Address
First Line	:	4740 N 37TH ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2237
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4740 N 37TH ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2237
Country	:	US
Telephone Number	:	954-961-6345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	06/08/2012

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