Provider Demographics
NPI:1942581087
Name:GARDEN CITY MEDICAL OFFICE PLLC
Entity Type:Organization
Organization Name:GARDEN CITY MEDICAL OFFICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-695-1700
Mailing Address - Street 1:1075 FRANKLIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2930
Mailing Address - Country:US
Mailing Address - Phone:516-575-1700
Mailing Address - Fax:
Practice Address - Street 1:1075 FRANKLIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2930
Practice Address - Country:US
Practice Address - Phone:516-575-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty