Organization
THE PROVIDER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY GAMBUZZA (COO)
(718) 866-8008
Entity
Organization
Contact information
Practice address
2717 CRESCENT ST, SUITE 5A, ASTORIA, NY 11102-2507
(718) 866-8008
Mailing address
2717 CRESCENT ST, SUITE 5A, ASTORIA, NY 11102-2507
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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