| | Physician Last Name: | Surpris |
| | Physician First Name: | Guy |
| | Physician Middle Name: | |
| | Address: | 186-04 121st Avenue
St. Albans, New York 11412 |
| | License Number: | 152432 |
| | License Type: | MD |
| | Year of Birth: |
|
| | Effective Date: | 01/29/1993 |
| | Action Description for DOH Webpage: | License revocation |
| | Misconduct Description for DOH Webpage: | The Review Board sustained the Hearing Committee's October 16, 1992 penalty and determination finding the physician guilty of having been convicted in New York State Supreme Court, New York County of grand larceny by falsely billing the Medicaid Program. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
