| Doctor Name: | DR. ILENE GEWIRTZ |
| NPI Number: | 1265405500 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 163315 |
| Business Practice Address: | 369 E Main St Suite11 Bldg 2 East Islip, NY - 117302800 |
| Business Phone Number: | 6318599793 |
| Business Fax Number: | 6312774608 |
| Mailing Address: | 369 E Main St, Suite11 Bldg 2 EAST ISLIP |
| State: | NY |
| Postal Code: | 117302800 |
| Phone Number: | 6318599793 |
| Fax Number: | 6312774608 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 03/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 163315 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |