| Jorge L. Gardyn, M.d., F.a.c.p., P.c. | |
|
4 Dorothy Gate Massapequa NY 11758-3521 | |
| (516) 795-5544 | |
| (516) 797-1826 |
| Full Name | Jorge L. Gardyn, M.d., F.a.c.p., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4 Dorothy Gate, Massapequa, New York |
| Authorized Official Name and Position | Jorge L. Gardyn (PRESIDENT) |
| Authorized Official Contact | 5167955544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge L. Gardyn, M.d., F.a.c.p., P.c. 4 Dorothy Gate Massapequa NY 11758-3521 Ph: (516) 795-5544 | Jorge L. Gardyn, M.d., F.a.c.p., P.c. 4 Dorothy Gate Massapequa NY 11758-3521 Ph: (516) 795-5544 |
| NPI Number | 1740584333 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 12/22/2010 |
| Medicare PECOS PAC ID | 5193908663 |
|---|---|
| Medicare Enrollment ID | O20110523000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740584333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 164119 (New York) | Primary |
| Provider Name | Jorge L. Gardyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629060983 PECOS PAC ID: 6002099579 Enrollment ID: I20110523000184 |
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