112 GVR MEDICAL, PC

NPI 1649315771 Active Family Medicine

Quick Facts

NPI Number

1649315771

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2007-02-20

Last Updated (NPPES)

2020-08-22

Primary Specialty / Taxonomy

Taxonomy	Family Medicine
Taxonomy Code	`207Q00000X`
License	220405 NY

Practice Address

6960 108TH ST
SUITE 108
FOREST HILLS, NY 113754323

Phone: 718-263-0200

Fax: 718-263-0205

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.