Healthcare Provider Details

I. General information

NPI: 1366416182
Provider Name (Legal Business Name): CHANA E. GELBFISH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 05/02/2013
Certification Date:
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: 718-258-1400
  • Fax: 718-421-0628
Mailing address:
  • Phone: 718-258-1400
  • Fax: 718-421-0628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number150668-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: