Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 292786 | NY |
NPI | 1023364643 |
---|---|
Provider Name | Dr. Semyon Gurgov |
First Address | Brooklyn, NY 11212-3139 |
Second Address | Greenlawn, NY 11740-1624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 17/09/2019 |