Provider Demographics
NPI:1598089765
Name:GYN-ONCOLOGY GROUP,PSC
Entity Type:Organization
Organization Name:GYN-ONCOLOGY GROUP,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANTOS REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-405-3660
Mailing Address - Street 1:PO BOX
Mailing Address - Street 2:362422
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2422
Mailing Address - Country:US
Mailing Address - Phone:805-405-3660
Mailing Address - Fax:
Practice Address - Street 1:AUXILIO CENTRO DE CANCER, 715 PONCE DE LEON AV
Practice Address - Street 2:PARADA 37 1/2 ,EDIF. NINO JESUS 4TO PISO
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:805-405-3660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty