Healthcare Provider Details

I. General information

NPI: 1841289063
Provider Name (Legal Business Name): SANFORD NEAL GERBER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 HEMPSTEAD TPKE
ELMONT NY
11003-2365
US

IV. Provider business mailing address

1561 HEMPSTEAD TPKE
ELMONT NY
11003-2365
US

V. Phone/Fax

Practice location:
  • Phone: 516-775-1212
  • Fax: 516-775-6500
Mailing address:
  • Phone: 516-775-1212
  • Fax: 516-775-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number032635
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: