Provider Demographics
NPI:1730134339
Name:GILL, GURMIT S (MD)
Entity Type:Individual
Prefix:DR
First Name:GURMIT
Middle Name:S
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4771
Mailing Address - Country:US
Mailing Address - Phone:516-741-0055
Mailing Address - Fax:516-745-8008
Practice Address - Street 1:623 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4771
Practice Address - Country:US
Practice Address - Phone:516-741-0055
Practice Address - Fax:516-745-8008
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182198-1207RP1001X, 207R00000X, 207RS0012X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01369891Medicaid
NY01369891Medicaid
NYG400026626Medicare PIN
NY7V04710Medicare PIN