Organization
GRAMERCY MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN WINHEIM (CREDENTIALING AGENT)
(845) 270-7648
Entity
Organization
Contact information
Practice address
3120 54TH ST STE L2, WOODSIDE, NY 11377-1549
(718) 476-5859
Mailing address
3120 54TH ST STE L2, WOODSIDE, NY 11377-1549
(718) 476-5859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821120833
INDIVIDUAL NPI
NY
Enumeration date
05/29/2018
Last updated
05/29/2018
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