Provider Demographics
NPI:1336633239
Name:GS MEDICAL PRACTICE PLLC
Entity Type:Organization
Organization Name:GS MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GHULAMULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHZAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-784-8331
Mailing Address - Street 1:957 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2821
Mailing Address - Country:US
Mailing Address - Phone:516-721-4648
Mailing Address - Fax:516-706-6026
Practice Address - Street 1:19303 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1874
Practice Address - Country:US
Practice Address - Phone:516-721-4648
Practice Address - Fax:516-706-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty