Provider Demographics
NPI:1841874831
Name:GARY TOLLIN MEDICINE, PC
Entity type:Organization
Organization Name:GARY TOLLIN MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-225-8903
Mailing Address - Street 1:2667 RACHEL ST
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5413
Mailing Address - Country:US
Mailing Address - Phone:516-225-8903
Mailing Address - Fax:
Practice Address - Street 1:896 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2328
Practice Address - Country:US
Practice Address - Phone:516-798-5552
Practice Address - Fax:516-541-3051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care