Provider Demographics
NPI:1235334061
Name:TAYLOR, GEORGE H (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:H
Other - Last Name:OLIVO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:506 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:718-622-2608
Mailing Address - Fax:718-622-5104
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:702-755-6448
Practice Address - Fax:718-622-5104
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229076207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH52731Medicare UPIN