Individual
DR. GEORGE RUSSELL AUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
990 STEWART AVE., GARDEN CITY, NY 11530
(516) 222-4294
(516) 222-4880
Mailing address
990 STEWART AVE., SUITE 100, GARDEN CITY, NY 11530
(516) 222-4294
(516) 222-4880
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
170392
NY
2085R0202X
Diagnostic Radiology Physician
Primary
170392-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01034711
—
NY
Enumeration date
01/22/2006
Last updated
12/29/2014
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