| Gopal Kishore Physician Pc | |
|
9 Fordham Dr Plainview NY 11803-1207 | |
| (631) 271-9151 | |
| (631) 271-9155 |
| Full Name | Gopal Kishore Physician Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9 Fordham Dr, Plainview, New York |
| Authorized Official Name and Position | Gopal Kishore (OWNER) |
| Authorized Official Contact | 6312719151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gopal Kishore Physician Pc 9 Fordham Dr Plainview NY 11803-1207 Ph: (631) 271-9151 | Gopal Kishore Physician Pc 9 Fordham Dr Plainview NY 11803-1207 Ph: (631) 271-9151 |
| NPI Number | 1164699146 |
|---|---|
| Provider Enumeration Date | 05/09/2008 |
| Last Update Date | 05/09/2008 |
| Medicare PECOS PAC ID | 4789753955 |
|---|---|
| Medicare Enrollment ID | O20080514000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164699146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Gopal Kishore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730260332 PECOS PAC ID: 0042310674 Enrollment ID: I20070712000141 |
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