Basic Information
| Provider Information | |||||||||
| NPI: | 1558503219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILL | ||||||||
| FirstName: | GAGANDEEP | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 RESEARCH WAY SUITE 204 | ||||||||
| Address2: | STONY BROOK ADMINISTRATIVE SERVICES LLC | ||||||||
| City: | EAST SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316158279 | ||||||||
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| Practice Location | |||||||||
| Address1: | 205 N. BELLE MEADE RD. | ||||||||
| Address2: | STONY BROOK INTERNAL MEDICINE | ||||||||
| City: | E. SETAUKET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314444630 | ||||||||
| FaxNumber: | 6314444617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2009 | ||||||||
| LastUpdateDate: | 04/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 270751 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.