Provider Demographics
NPI:1295047678
Name:GARY B ORIN MD PC
Entity type:Organization
Organization Name:GARY B ORIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:ORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-288-4300
Mailing Address - Street 1:311 E 79TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0999
Mailing Address - Country:US
Mailing Address - Phone:212-288-4300
Mailing Address - Fax:212-288-4466
Practice Address - Street 1:311 E 79TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0999
Practice Address - Country:US
Practice Address - Phone:212-288-4300
Practice Address - Fax:212-288-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150484207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01040413Medicaid
NY01040413Medicaid
NYB17157Medicare UPIN