Provider Demographics
NPI:1831219724
Name:STONE GATE OB GYN
Entity type:Organization
Organization Name:STONE GATE OB GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZZETTE
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-880-0800
Mailing Address - Street 1:16303 HORACE HARDING EXPY STE 300
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1449
Mailing Address - Country:US
Mailing Address - Phone:866-880-0800
Mailing Address - Fax:
Practice Address - Street 1:16303 HORACE HARDING EXPY STE 300
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1449
Practice Address - Country:US
Practice Address - Phone:866-880-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197255207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1C3442Medicare ID - Type UnspecifiedGHI MEDICARE