Provider Demographics
NPI:1396184453
Name:GAAMA MEDICAL CARE PC
Entity Type:Organization
Organization Name:GAAMA MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDELL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GORUM
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:646-577-7442
Mailing Address - Street 1:142-07 174TH STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-651-4005
Practice Address - Street 1:142-07 174TH STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413
Practice Address - Country:US
Practice Address - Phone:646-577-7442
Practice Address - Fax:866-651-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013921207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty