Provider Demographics
NPI:1366529976
Name:NYMIS MEDICAL P.C.
Entity type:Organization
Organization Name:NYMIS MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PISKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-645-6304
Mailing Address - Street 1:1502 E 14TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7148
Mailing Address - Country:US
Mailing Address - Phone:718-645-6304
Mailing Address - Fax:
Practice Address - Street 1:1502 E 14TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7148
Practice Address - Country:US
Practice Address - Phone:718-645-6304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY213636-NYOther1199/NBF
NY0103577OtherGHI
NYP1876819OtherOXFORD
NY01934174Medicaid
NY13191OtherELDERPLAN
NYN74176OtherHEALTH NET
NY460H01OtherBCBS
NY13191OtherELDERPLAN
NY81L311Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #
NYP1876819OtherOXFORD