MEDICARE: ANDREW E GEWIRTZ 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	207W00000X	Ophthalmology Physician	138815	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	:	1982601191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW E GEWIRTZ MD

Provider Business Mailing Address
First Line	:	524 E 20TH ST
Second Line	:	4H
City	:	NEW YORK
State	:	NY
Zip	:	10009-1302
Country	:	US
Telephone Number	:	212-792-8192
Fax Number	:	212-253-8002

Provider Business Practice Location Address
First Line	:	524 E 20TH ST
Second Line	:	4H
City	:	NEW YORK
State	:	NY
Zip	:	10009-1302
Country	:	US
Telephone Number	:	212-995-8458
Fax Number	:	212-253-8002

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	04/27/2015

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