Healthcare Provider Details

I. General information

NPI: 1073298154
Provider Name (Legal Business Name): RICHARD A GASALBERTI M D SPORTS MEDICINE & REHABILITATION P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3146 E TREMONT AVE
BRONX NY
10461-5706
US

IV. Provider business mailing address

11510 QUEENS BLVD
FOREST HILLS NY
11375-7015
US

V. Phone/Fax

Practice location:
  • Phone: 718-792-6503
  • Fax: 718-792-0096
Mailing address:
  • Phone: 718-544-7700
  • Fax: 718-793-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD A GASALBERTI
Title or Position: MD
Credential: MD
Phone: 718-544-7700