# SGR MEDICAL DOCTOR P.C.

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

## Provider details

- **NPI number:** 1992296677
- **Authorized official:** XIOMARA M SANTOS M.D (PHYCOLOGY)
- **Authorized official phone:** (212) 928-1400

## Contact information

- **Practice address:** 395 FORT WASHINGTON AVE, SUITE 6, NEW YORK, NY 10033-6728
- **Practice address phone:** (212) 928-1400
- **Practice address fax:** (212) 923-5595
- **Mailing address:** 395 FORT WASHINGTON AVE, SUITE 6, NEW YORK, NY 10033-6728
- **Mailing address phone:** (212) 928-1400
- **Mailing address fax:** (212) 923-5595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 07/26/2019