Healthcare Provider Details

I. General information

NPI: 1316982663
Provider Name (Legal Business Name): DR. JANICE L GELFAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3765 RIVERDALE AVE
BRONX NY
10463-1845
US

IV. Provider business mailing address

3765 RIVERDALE AVE
BRONX NY
10463-1845
US

V. Phone/Fax

Practice location:
  • Phone: 718-361-3482
  • Fax: 718-601-6102
Mailing address:
  • Phone: 718-361-3482
  • Fax: 718-601-6102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number172044
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: