Provider Demographics
NPI:1366715583
Name:GU, BIN
Entity type:Individual
Prefix:
First Name:BIN
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 271ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1504
Mailing Address - Country:US
Mailing Address - Phone:516-321-3000
Mailing Address - Fax:
Practice Address - Street 1:450 LAKEVILLE RD, DEPT RADIATION MEDICINE
Practice Address - Street 2:
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042-1118
Practice Address - Country:US
Practice Address - Phone:516-321-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-18
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015274363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant