Healthcare Provider Details

I. General information

NPI: 1740310317
Provider Name (Legal Business Name): ALEX GILELS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 W MIDLAND AVE
PARAMUS NJ
07652-1801
US

IV. Provider business mailing address

99 W MIDLAND AVE
PARAMUS NJ
07652-1801
US

V. Phone/Fax

Practice location:
  • Phone: 917-660-4180
  • Fax:
Mailing address:
  • Phone: 917-660-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00292100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number006206
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: