Healthcare Provider Details

I. General information

NPI: 1063966265
Provider Name (Legal Business Name): KARIN GAMBARO M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ASTRONOMY LN
LEVITTOWN NY
11756-4301
US

IV. Provider business mailing address

1 ASTRONOMY LN
LEVITTOWN NY
11756-4301
US

V. Phone/Fax

Practice location:
  • Phone: 516-512-2196
  • Fax:
Mailing address:
  • Phone: 516-512-2196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: