GRAND STREET MEDICAL PLLC; NPI #1568485985

Contact Information

GRAND STREET MEDICAL PLLC

666 GRAND ST
BROOKLYN, NY 11211-4853

Phone: 718-963-0555
Fax: 718-963-4889
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Addiction Medicine	207QA0401X	08	Physician/Family Practice
Family Medicine	207Q00000X	08	Physician/Family Practice
Geriatric Medicine	207QG0300X	08	Physician/Family Practice
Geriatric Medicine	207RG0300X	11	Physician/Internal Medicine
Internal Medicine	207R00000X	11	Physician/Internal Medicine
Medical Oncology	207RX0202X	11	Physician/Internal Medicine
Physical Medicine & Rehabilitation	208100000X	25	Physician/Physical Medicine and Rehabilitation
Surgery	208600000X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for GRAND STREET MEDICAL PLLC

NPI Number 1568485985

LBN Legal business name GRAND STREET MEDICAL PLLC

Authorized official HEMA GANDHI - (ADMINISTRATION)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/26/2006

Last updated 04/18/2012 - About 14 years ago

Identifiers

NY	License #	111281
NY	Medicaid	00199748
NY	Medicaid	03196274
NY	Medicaid	WPPD41
	Other	12295130	CAQH
NY	Other	11128160NY	1199 NATIONAL BENEFIT
NY	Other	GJ617239	GHI
NY	Other	0192659	GRAND STREET MEDICAL PC
NY	Other	55247	HIP

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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GRAND STREET MEDICAL PLLC

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NPI Profile & details for GRAND STREET MEDICAL PLLC

Reviews for GRAND STREET MEDICAL PLLC