Organization
ACTIVE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A GLUCK MD (PRESIDENT)
(718) 878-2224
Entity
Organization
Contact information
Practice address
43-44 KISSENA BLVD,, SUITE LA, FLUSHING, NY 11355
(718) 878-2224
Mailing address
PO BOX 528160, FLUSHING, NY 11352
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
108577
NY
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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