Provider Demographics
NPI:1043276447
Name:OWENS, GEORGE F (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:OWENS
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 1:311 NORTH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2217
Mailing Address - Country:US
Mailing Address - Phone:914-946-1406
Mailing Address - Fax:
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-946-1406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143296208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00842457Medicaid
NY00842457Medicaid
NYCO6985Medicare UPIN
NY00842457Medicaid