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Organization

GVPDO MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE M VASCONEZ PEREIRA DO (DIRECTOR)
(212) 929-3334
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
216012
NY

Other

Enumeration date
07/18/2011
Last updated
07/19/2011
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