Healthcare Provider Details

I. General information

NPI: 1326452467
Provider Name (Legal Business Name): KAY TALYA GUBBAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MANHATTAN AVE
BROOKLYN NY
11222-2227
US

IV. Provider business mailing address

312 E 92ND ST APT 2D
NEW YORK NY
10128-5438
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-3220
  • Fax:
Mailing address:
  • Phone: 646-429-9009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number197328-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: