Healthcare Provider Details

I. General information

NPI: 1144552175
Provider Name (Legal Business Name): BERNARD L GELBARD B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 RED SCHOOLHOUSE RD
CHESTNUT RIDGE NY
10977-7053
US

IV. Provider business mailing address

80 RED SCHOOLHOUSE RD SUITE 226
CHESTNUT RIDGE NY
10977-7053
US

V. Phone/Fax

Practice location:
  • Phone: 845-371-8600
  • Fax: 845-356-2552
Mailing address:
  • Phone: 845-371-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number021395
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: