Healthcare Provider Details

I. General information

NPI: 1316210990
Provider Name (Legal Business Name): ARI GELIEBTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W PASSAIC ST STE 14
MAYWOOD NJ
07607-1264
US

IV. Provider business mailing address

240 W PASSAIC ST STE 14
MAYWOOD NJ
07607-1264
US

V. Phone/Fax

Practice location:
  • Phone: 201-903-0070
  • Fax: 201-322-0287
Mailing address:
  • Phone: 201-903-0070
  • Fax: 201-322-0287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number269319
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25MA09882400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number269319
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: