Provider Demographics
NPI:1598071995
Name:IRENE G GURVITS, MD, PC
Entity Type:Organization
Organization Name:IRENE G GURVITS, MD, PC
Other - Org Name:MEDPSYCH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GURVITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-874-5400
Mailing Address - Street 1:102 W 75TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1904
Mailing Address - Country:US
Mailing Address - Phone:212-874-5400
Mailing Address - Fax:212-874-1560
Practice Address - Street 1:102 W 75TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-1904
Practice Address - Country:US
Practice Address - Phone:212-874-5400
Practice Address - Fax:212-874-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208209207R00000X, 2084P0800X
2084B0002X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084B0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyObesity MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1872655Medicaid
NY1872655Medicaid