Healthcare Provider Details

I. General information

NPI: 1750321022
Provider Name (Legal Business Name): HAROLD M. GELIEBTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59-25 KISSENA BLVD
FLUSHING NY
11355
US

IV. Provider business mailing address

59-25 KISSENA BLVD
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-6100
  • Fax: 718-670-6110
Mailing address:
  • Phone: 718-670-6100
  • Fax: 718-670-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number120541
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: