Gavriil Agaon, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

222861 Issued in NY

Legal business name

GAVRIIL AGAON, M.D., P.C.

Practice address

9972 66TH Rd
Suite - LH
Rego Park, NY 11374-4460

Phone

(718) 532-3131

Fax

(718) 997-8040

NPI assigned

Jan 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gavriil Agaon, M.D.NPI 1699858506

Title

President

Phone

(718) 532-3131

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gavriil Agaon, M.D.

  • Internal Medicine Physician
  • Rego Park, NY
  • NPI 1699858506
  NPD (past) Authorized official

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1851697619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 102ND ST",
            "address_2": "APT - 7T",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752453",
            "telephone_number": "718-275-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9972 66TH RD",
            "address_2": "SUITE - LH",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744460",
            "telephone_number": "718-532-3131",
            "fax_number": "718-997-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVRIIL AGAON, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "AGAON",
        "authorized_official_first_name": "GAVRIIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-532-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "222861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02243589",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "05035",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Mark Ganz, D.C.
• Michelle Garavaglia
• Anna Garcia, OTR/L
• Rebecca Stanski Garcia, RD
• Yvette Garcia, LMSW
• Susanna Gavrilova, DR
• Yelena Gavrilova
• Violetta Gavriyelov
• Sonya Gavriyelova
• Gal Gazit, M.D.

• Internal Medicine Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.