Provider Demographics
NPI:1629577804
Name:PERINATAL DIAGNOSTIC CENTERS OF NEW YORK & NEW JERSEY
Entity type:Organization
Organization Name:PERINATAL DIAGNOSTIC CENTERS OF NEW YORK & NEW JERSEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:GUIRGUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO, FACOG, MFM
Authorized Official - Phone:929-754-1667
Mailing Address - Street 1:174 LILY POND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4608
Mailing Address - Country:US
Mailing Address - Phone:833-732-1131
Mailing Address - Fax:201-608-0497
Practice Address - Street 1:174 LILY POND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4608
Practice Address - Country:US
Practice Address - Phone:833-732-1131
Practice Address - Fax:201-608-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2844091207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty