Organization
GENERAL 1 MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAZELLE CRAIG D.O (PRESIDENT)
(212) 962-2262
Entity
Organization
Contact information
Practice address
130 WILLIAM ST, SUITE 903, NEW YORK, NY 10038-3806
(212) 962-2262
(212) 962-7472
Mailing address
130 WILLIAM ST, SUITE 903, NEW YORK, NY 10038-3806
(212) 962-2262
(212) 962-7472
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100079641
MEDICARE PTAN
NY
01
—
A400015770
MEDICARE PTAN
NY
Enumeration date
04/05/2012
Last updated
04/09/2014
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