General 1 Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

GENERAL 1 MEDICAL PC

Practice address

130 William St
Suite 903
New York, NY 10038-3806

Phone

(212) 962-2262

Fax

(212) 962-7472

NPI assigned

Apr 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gazelle Craig, D.O

Title

President

Phone

(212) 962-2262

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1356607154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WILLIAM ST",
            "address_2": "SUITE 903",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383806",
            "telephone_number": "212-962-2262",
            "fax_number": "212-962-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WILLIAM ST",
            "address_2": "SUITE 903",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383806",
            "telephone_number": "212-962-2262",
            "fax_number": "212-962-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL 1 MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "GAZELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-962-2262",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A400015770",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A100079641",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.