Provider Demographics
NPI:1356320121
Name:VEITH, GARY EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:EDWIN
Last Name:VEITH
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 1:61 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8366
Mailing Address - Country:US
Mailing Address - Phone:631-659-1600
Mailing Address - Fax:
Practice Address - Street 1:61 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8366
Practice Address - Country:US
Practice Address - Phone:631-659-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130824207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAH01401OtherMDNY
NY2512OtherVYTRA
NY43336POtherHIP
NY2590504OtherGHI
NYB12800Medicare UPIN
NY315791Medicare ID - Type Unspecified
NY608P71OtherEMPIRE BCBS
NY1274098002OtherCIGNA
NYCS323OtherOXFORD
NY00271018Medicaid
NY3777588OtherAETNA/US HEALTHCARE