Great Wall Medical, P.C.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

GREAT WALL MEDICAL, P.C.

Doing business as

New York Robotic Gynecology & Women's Health

Practice address

201E 28TH Street
Suite #1B
New York, NY 10016

Phone

(212) 481-1118

Fax

(212) 448-1049

NPI assigned

Jan 3, 2019

Organization subpart

No

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

Authorized official

Name

Joon Song, M.D.

Title

Medical Doctor/C.E.O.

Phone

(212) 481-1118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New York Robotic Gynecology & Women's Health Doing business as

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1699248542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201E 28TH STREET",
            "address_2": "SUITE #1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-481-1118",
            "fax_number": "212-448-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201E 28TH STREET",
            "address_2": "SUITE #1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-481-1118",
            "fax_number": "212-448-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT WALL MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JOON",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/C.E.O.",
        "authorized_official_telephone_number": "212-481-1118",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02907826",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Robotic Gynecology & Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Gynecology Physician in New York, NY
• Providers in New York, NY by specialty
• Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.