Provider Demographics
NPI:1689843799
Name:JERROLD M GORSKI MD PC
Entity Type:Organization
Organization Name:JERROLD M GORSKI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERROLD
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-741-6900
Mailing Address - Street 1:181 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2053
Mailing Address - Country:US
Mailing Address - Phone:516-741-6900
Mailing Address - Fax:
Practice Address - Street 1:181 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2053
Practice Address - Country:US
Practice Address - Phone:516-741-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
JG023D6810Medicare PIN
23D681Medicare PIN