Provider Demographics
NPI:1447405246
Name:GREGORY J PAMEL MD PC
Entity Type:Organization
Organization Name:GREGORY J PAMEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:212-355-2215
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8183
Mailing Address - Country:US
Mailing Address - Phone:212-355-2215
Mailing Address - Fax:212-355-6930
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8183
Practice Address - Country:US
Practice Address - Phone:212-355-2215
Practice Address - Fax:212-355-6930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194606174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01465567Medicaid
NY02107757Medicaid
NY01465567Medicaid
NY02107757Medicaid