Provider Demographics
NPI:1053428284
Name:ORIN, GARY BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:BRUCE
Last Name:ORIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:311 E 79TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0999
Mailing Address - Country:US
Mailing Address - Phone:212-288-4300
Mailing Address - Fax:212-288-4466
Practice Address - Street 1:311 E 79TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0999
Practice Address - Country:US
Practice Address - Phone:212-288-4300
Practice Address - Fax:212-288-4466
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2011-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY150484207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01040413Medicaid
NY01040413Medicaid
NYB17157Medicare UPIN