Provider Demographics
NPI:1568089902
Name:GAGOS CARDIOVASCULAR MEDICINE PLLC
Entity Type:Organization
Organization Name:GAGOS CARDIOVASCULAR MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIOS
Authorized Official - Middle Name:D
Authorized Official - Last Name:GAGOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-440-8401
Mailing Address - Street 1:2747 CRESCENT ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3142
Mailing Address - Country:US
Mailing Address - Phone:718-440-8401
Mailing Address - Fax:718-440-8407
Practice Address - Street 1:2747 CRESCENT ST STE 206
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3142
Practice Address - Country:US
Practice Address - Phone:718-440-8401
Practice Address - Fax:718-440-8407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty