| Gramercy Medical Pc | |
|
3120 54th St Ste L2 Woodside NY 11377-1549 | |
| (718) 476-5859 | |
| Not Available |
| Full Name | Gramercy Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3120 54th St Ste L2, Woodside, New York |
| Authorized Official Name and Position | Mary Ann Winheim (CREDENTIALING AGENT) |
| Authorized Official Contact | 8452707648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gramercy Medical Pc 3120 54th St Ste L2 Woodside NY 11377-1549 Ph: (718) 476-5859 | Gramercy Medical Pc 3120 54th St Ste L2 Woodside NY 11377-1549 Ph: (718) 476-5859 |
| NPI Number | 1174014971 |
|---|---|
| Provider Enumeration Date | 05/29/2018 |
| Last Update Date | 05/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174014971 | NPI | - | NPPES |
| 1821120833 | Other | NY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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