# GVPDO MEDICINE PC

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

## Provider details

- **NPI number:** 1124316690
- **Authorized official:** GRACE M VASCONEZ PEREIRA DO (DIRECTOR)
- **Authorized official phone:** (212) 929-3334

## Contact information

- **Practice address:** 20 W 38TH ST, SUITE 306, NEW YORK, NY 10018-6228
- **Practice address phone:** (212) 768-1600
- **Practice address fax:** (212) 768-1606
- **Mailing address:** 231 W 15TH ST, SUITE 1C, NEW YORK, NY 10011-6433
- **Mailing address phone:** (212) 929-3334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 216012 | NY | Yes |

## Other

- **Enumeration date:** 07/18/2011
- **Last updated:** 07/19/2011