Provider Demographics
NPI:1982068078
Name:GORIS, SILVIO (MD)
Entity Type:Individual
Prefix:
First Name:SILVIO
Middle Name:
Last Name:GORIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2205
Mailing Address - Country:US
Mailing Address - Phone:718-670-5939
Mailing Address - Fax:
Practice Address - Street 1:3400 TIBBETT AVE
Practice Address - Street 2:APT 2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3766
Practice Address - Country:US
Practice Address - Phone:203-745-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine