MEDICARE: MRS. E MATTIE GELBFISH P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	006749	NY

General Provider Information

NPI Number	:	1619207172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. E MATTIE GELBFISH P.A.

Provider Business Mailing Address
First Line	:	4813 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2484
Country	:	US
Telephone Number	:	718-283-8864
Fax Number	:

Provider Business Practice Location Address
First Line	:	4813 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2484
Country	:	US
Telephone Number	:	718-283-8864
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	01/22/2026

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