Provider Demographics
NPI:1588744585
Name:GENDAL-KUSNITZ OBS-GYN M.D P.C
Entity type:Organization
Organization Name:GENDAL-KUSNITZ OBS-GYN M.D P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUSNITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-487-4433
Mailing Address - Street 1:833 NORTHERN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5315
Mailing Address - Country:US
Mailing Address - Phone:516-487-4433
Mailing Address - Fax:516-487-2556
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5315
Practice Address - Country:US
Practice Address - Phone:516-487-4433
Practice Address - Fax:516-487-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty