Provider Demographics
NPI:1558356063
Name:SIROUNIAN, GREGORY H (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:H
Last Name:SIROUNIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9004
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85068-9004
Mailing Address - Country:US
Mailing Address - Phone:623-512-4359
Mailing Address - Fax:623-512-4364
Practice Address - Street 1:1300 FRANKLIN AVE
Practice Address - Street 2:SUITE UL3A
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1886
Practice Address - Country:US
Practice Address - Phone:516-747-8900
Practice Address - Fax:516-663-8166
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30048207X00000X
NY261465-1207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery