Organization
DEMOCLEIA GOTTESMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMOCLEIA GOTTESMAN MD (PRESIDENT)
(718) 934-4842
Entity
Organization
Contact information
Practice address
415 OCEANVIEW AVENUE, BROOKLYN, NY 11235
(718) 934-4842
(718) 616-0165
Mailing address
415 OCEANVIEW AVENUE, BROOKLYN, NY 11235
(718) 934-4842
(718) 616-0165
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
181011
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01356463
—
NY
01
—
07402
GHI MEDICARE
—
Enumeration date
07/06/2006
Last updated
06/04/2010
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