# EMPIRE GATE MEDICAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003188020
- **Authorized official:** MR. ROBERT GORDON (COO)
- **Authorized official phone:** (646) 217-4610

## Contact information

- **Practice address:** 8810 PARSONS BLVD, JAMAICA, NY 11432-3842
- **Practice address phone:** (718) 291-8111
- **Practice address fax:** (718) 487-9343
- **Mailing address:** 111 BROADWAY, \#1005, NEW YORK, NY 10006-1951
- **Mailing address phone:** (646) 217-4610
- **Mailing address fax:** (917) 591-8596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | 163293 | NY | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2012
- **Last updated:** 05/22/2014