Provider Demographics
NPI:1750698197
Name:GC MEDICAL P.C.
Entity type:Organization
Organization Name:GC MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-385-1525
Mailing Address - Street 1:3 BREWSTER ST
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2510
Mailing Address - Country:US
Mailing Address - Phone:516-759-7702
Mailing Address - Fax:516-674-0572
Practice Address - Street 1:3 BREWSTER ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2510
Practice Address - Country:US
Practice Address - Phone:516-759-7702
Practice Address - Fax:516-674-0572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty