Provider Demographics
NPI:1013471978
Name:GIL MEDICAL SERVICES P C
Entity Type:Organization
Organization Name:GIL MEDICAL SERVICES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTO
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNY
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:GIL SARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-507-9878
Mailing Address - Street 1:3722 88TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7631
Mailing Address - Country:US
Mailing Address - Phone:718-507-9878
Mailing Address - Fax:718-507-9894
Practice Address - Street 1:3722 88TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7631
Practice Address - Country:US
Practice Address - Phone:718-507-9878
Practice Address - Fax:718-507-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04572625Medicaid