Provider Demographics
NPI:1477601383
Name:EXCEL MEDICAL CARE
Entity Type:Organization
Organization Name:EXCEL MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRZEJ
Authorized Official - Middle Name:J
Authorized Official - Last Name:GACEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-961-5060
Mailing Address - Street 1:4348 COLDEN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3934
Mailing Address - Country:US
Mailing Address - Phone:718-961-5060
Mailing Address - Fax:718-961-5900
Practice Address - Street 1:4348 COLDEN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3934
Practice Address - Country:US
Practice Address - Phone:718-961-5060
Practice Address - Fax:718-961-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238703208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI53137Medicare UPIN