Organization
GT MEDICAL PC
Active
Other names
Queens Medical Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QIAO DONG GUO M.D. (PRESIDENT)
(347) 947-7692
Entity
Organization
Contact information
Practice address
9436 58TH AVE # G4, ELMHURST, NY 11373
(347) 947-7692
(347) 947-7680
Mailing address
9436 58TH AVE # G4, ELMHURST, NY 11373-5149
(347) 947-7692
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
269058
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760624423
NPI
NY
Enumeration date
05/26/2016
Last updated
06/22/2018
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