Basic Information
| Provider Information | |||||||||
| NPI: | 1881991495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GORIN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9910 FRANKLIN SQUARE DR STE 2110 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212364902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109336423 | ||||||||
| FaxNumber: | 4109331390 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 CUBA HILL RD | ||||||||
| Address2: | |||||||||
| City: | GREENLAWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117401624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316285000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2011 | ||||||||
| LastUpdateDate: | 04/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | D82986 | MD | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 313957 | NY | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.