Organization
MEDICAL PROFESSIONAL GROUP
Active
Organization
MEDICAL PROFESSIONAL GROUP
Active
Other names
MEDICAL PROFESSIONAL GROUP, OMNICARE PLUS
Organization subpart
No
Provider details
NPI number
Authorized official
GINA DUVAL (ADMINSTRATOR)
(718) 433-0044
Entity
Organization
Contact information
Practice address
3110 37TH AVE STE 203, LONG ISLAND CITY, NY 11101-2112
(718) 433-0044
(718) 433-4644
Mailing address
3110 37TH AVE STE 202, LONG ISLAND CITY, NY 11101-2112
(718) 433-0044
(718) 255-6555
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
163744
NY
Other
Enumeration date
11/02/2010
Last updated
10/30/2025
Update your record
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