Doctor Name: | DR. LEO GORELKIN |
NPI Number: | 1306049960 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 244341 |
Business Practice Address: | 44 E 32nd St Trs New York, NY - 100165508 |
Business Phone Number: | 2126852848 |
Business Fax Number: | |
Mailing Address: | 165 W End Ave, #19b NEW YORK |
State: | NY |
Postal Code: | 100235503 |
Phone Number: | 2127241760 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 244341 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |