Healthcare Provider Details

I. General information

NPI: 1851396451
Provider Name (Legal Business Name): GABRIEL SPERGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 OCEAN PKWY APT 1H
BROOKLYN NY
11218-2579
US

IV. Provider business mailing address

135 OCEAN PKWY APT 1H
BROOKLYN NY
11218-2579
US

V. Phone/Fax

Practice location:
  • Phone: 718-853-3702
  • Fax: 718-853-3704
Mailing address:
  • Phone: 718-853-3702
  • Fax: 718-853-3704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number87865
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: