Provider Demographics
NPI:1134321763
Name:GORENSTEIN MEDICAL CARE, PC
Entity Type:Organization
Organization Name:GORENSTEIN MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZRAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1888-889-0010
Mailing Address - Street 1:290 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5504
Mailing Address - Country:US
Mailing Address - Phone:888-889-0010
Mailing Address - Fax:516-487-4156
Practice Address - Street 1:290 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5504
Practice Address - Country:US
Practice Address - Phone:888-889-0010
Practice Address - Fax:516-487-4156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH16075Medicare UPIN