Provider Demographics
NPI:1629088950
Name:WRIGHT, GEORGE O (MD FACS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:O
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B 230
Mailing Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8000
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-616-4105
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY175940-12086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01454397Medicaid
NYF22840Medicare UPIN
NY01454397Medicaid