OrganizationActive
112 Gvr Medical, PC
NPI 1649315771 · Family Medicine Physician · Forest Hills, NY
Provider details
- NPI number
- 1649315771
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Ida Tetro, Owner
- License
- 220405 (NY)
Practice location
6960 108th St
Suite 108
Forest Hills, NY 11375-4323
Phone: (718) 263-0200
Fax: (718) 263-0205
Mailing address
6960 108th St
Forest Hills, NY 11375-4323
Registry dates
- Enumerated
- 2007-02-20
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.