Provider Demographics
NPI:1538466388
Name:GLORIA K GURDZIEL MD LTD
Entity Type:Organization
Organization Name:GLORIA K GURDZIEL MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:KREIS
Authorized Official - Last Name:GURDZIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-340-7489
Mailing Address - Street 1:3076 BRICKHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6859
Mailing Address - Country:US
Mailing Address - Phone:757-340-7489
Mailing Address - Fax:757-340-7518
Practice Address - Street 1:3076 BRICKHOUSE CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6859
Practice Address - Country:US
Practice Address - Phone:757-340-7489
Practice Address - Fax:757-340-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010379912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty