Healthcare Provider Details

I. General information

NPI: 1568423663
Provider Name (Legal Business Name): GARY A. GELBFISH, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 AVENUE I
BROOKLYN NY
11210-2830
US

IV. Provider business mailing address

2502 AVENUE I
BROOKLYN NY
11210-2830
US

V. Phone/Fax

Practice location:
  • Phone: 718-258-3004
  • Fax: 718-421-8168
Mailing address:
  • Phone: 718-258-3004
  • Fax: 718-421-8168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number163406
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY GELBFISH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-258-3004