Provider Demographics
NPI:1992809982
Name:BESSER, GARY S (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:S
Last Name:BESSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W BROAD ST
Mailing Address - Street 2:STE G401 WHITTINGHAM PAVILION
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3633
Mailing Address - Country:US
Mailing Address - Phone:203-325-4321
Mailing Address - Fax:203-975-7515
Practice Address - Street 1:190 W BROAD ST
Practice Address - Street 2:STE G401 WHITTINGHAM PAVILION
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3633
Practice Address - Country:US
Practice Address - Phone:203-325-4321
Practice Address - Fax:203-975-7515
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026837207V00000X
NY5523899207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B39657Medicare UPIN
160001718Medicare ID - Type Unspecified