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Organization

436 GWB MEDICAL OFFICE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE A GORIS MD (MD)
(212) 923-0408
Entity
Organization

Contact information

Practice address
436 FORT WASHINGTON AVE APT 1A, NEW YORK, NY 10033-3533
(212) 923-0408
(212) 923-7051
Mailing address
435 FORT WASHINGTON AVE APT 2B, NEW YORK, NY 10033-3527
(212) 923-0408
(212) 923-7051

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01740610
NY
Enumeration date
10/10/2017
Last updated
10/10/2017
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