Organization
GRAHAM WELLNESS MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON CHARLES DAVIS D.O. (MEDICAL DIRECTOR)
(718) 566-0022
Entity
Organization
Contact information
Practice address
104 GRAHAM AVE, BROOKLYN, NY 11206-3320
(718) 218-6616
(718) 218-6634
Mailing address
104 GRAHAM AVE, BROOKLYN, NY 11206-3320
(718) 218-6616
(718) 218-6634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
171745
NY
Other
Enumeration date
02/28/2011
Last updated
02/28/2011
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