Organization
GARY S MEDOWS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY S MEDOWS MD (PRESIDENT)
(212) 260-5990
Entity
Organization
Contact information
Practice address
550 G GRAND ST, SUITE GF, NEW YORK CITY, NY 10002
(212) 260-5990
Mailing address
550 G GRAND ST, SUITE GF, NEW YORK CITY, NY 10002
(212) 260-5990
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
098846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059117
GHI
—
01
—
098843
HIP
—
01
—
2C 6307
PHS
—
01
—
5353537004
CIGNA
—
01
—
56411
UNITED
—
01
—
GM08391210
BS
—
01
—
P412791
OX
—
Enumeration date
03/06/2007
Last updated
08/22/2020
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