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Individual

DR. GUSTAVE STEPHEN DRIVAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
5405 HYLAN BLVD, STATEN ISLAND, NY 10312-5241
(718) 948-3890
(718) 948-3961
Mailing address
5405 HYLAN BLVD, STATEN ISLAND, NY 10312-5241
(718) 948-3890
(718) 948-3961

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
186334
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01522467
NY
Enumeration date
05/15/2006
Last updated
02/19/2008
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