Provider Demographics
NPI:1104864446
Name:EGLINTON, GARY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:SCOTT
Last Name:EGLINTON
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 1:5645 MAIN ST
Mailing Address - Street 2:DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-1534
Mailing Address - Fax:718-539-1669
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-1517
Practice Address - Fax:516-437-4167
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01080185A207VM0101X
NY215293207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02086813Medicaid
NY02086813Medicaid
NY02711Medicare PIN
NYE53243Medicare UPIN