Provider Demographics
NPI:1033124847
Name:GIRSHIN, GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:GIRSHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WOLFS LANE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803
Mailing Address - Country:US
Mailing Address - Phone:914-522-9039
Mailing Address - Fax:212-939-2759
Practice Address - Street 1:800 WOLFS LANE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803
Practice Address - Country:US
Practice Address - Phone:914-522-9039
Practice Address - Fax:212-939-2759
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252425-01207L00000X
NY000686207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02154727Medicaid
NY02154727Medicaid
NY0352T1Medicare ID - Type Unspecified