Organization
BON SECOURS CHARITY HEALTH SYSTEM MEDICAL GROUP, P.C.
Active
Other names
GSH Medical Care, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
LAURI QUIGLEY (CREDENTIALING MANAGER)
(845) 987-3906
Entity
Organization
Contact information
Practice address
20 GRAND ST, 3RD FLOOR, WARWICK, NY 10990-1035
(845) 987-3906
(845) 987-5979
Mailing address
20 GRAND ST, 3RD FLOOR, WARWICK, NY 10990-1035
(845) 987-3906
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03313839
—
NY
05
—
0538477
—
NJ
05
—
1022201690002
—
PA
01
—
CG4866
RAILROAD MEDICARE
NY
Enumeration date
06/08/2006
Last updated
07/14/2021
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