Provider Demographics
NPI:1174269039
Name:ROBERT COURGI LLC
Entity Type:Organization
Organization Name:ROBERT COURGI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOURGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-913-9993
Mailing Address - Street 1:59 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2744
Mailing Address - Country:US
Mailing Address - Phone:917-913-9993
Mailing Address - Fax:
Practice Address - Street 1:8565 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1804
Practice Address - Country:US
Practice Address - Phone:917-913-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty