Healthcare Provider Details

I. General information

NPI: 1275508954
Provider Name (Legal Business Name): GARY A. GELBFISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/03/2008
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: 718-258-3004
  • Fax: 718-421-8168
Mailing address:
  • Phone: 718-258-3004
  • Fax: 718-421-8168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number1634061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: