Graham Wellness Medical, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

171745 Issued in NY

Legal business name

GRAHAM WELLNESS MEDICAL, P.C.

Practice address

104 Graham Ave
Brooklyn, NY 11206-3320

Phone

(718) 218-6616

Fax

(718) 218-6634

NPI assigned

Feb 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Charles Davis, D.O.

Title

Medical Director

Phone

(718) 566-0022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1386941300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063320",
            "telephone_number": "718-218-6616",
            "fax_number": "718-218-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063320",
            "telephone_number": "718-218-6616",
            "fax_number": "718-218-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM WELLNESS MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-28",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-566-0022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "171745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graham Eye Care LLC
• Cesialina Graham Gondola
• Graham Medical Services PC
• Graham Neurology, P.C.
• Graham RX Corp
• Graham Windham
• Barakel Graham Graham-Benfield
• Beverly Dianne Graham-Fournillier, MSW
• Suzette Blondelle Graham-Hill, MD
• Ethan Graham-Horowitz

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.