Healthcare Provider Details

I. General information

NPI: 1528237385
Provider Name (Legal Business Name): GELBART & KESSELMAN P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 ROUTE 22
BREWSTER NY
10509-4051
US

IV. Provider business mailing address

1620 ROUTE 22
BREWSTER NY
10509-4051
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-4999
  • Fax:
Mailing address:
  • Phone: 845-279-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number034702
License Number StateNY

VIII. Authorized Official

Name: CARLA MULLENIX
Title or Position: OFFICE MANAGER
Credential:
Phone: 845-279-4999