Healthcare Provider Details

I. General information

NPI: 1821259201
Provider Name (Legal Business Name): SCOTT C GELBER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HICKSVILLE RD
MASSAPEQUA NY
11758-5823
US

IV. Provider business mailing address

100 HICKSVILLE RD
MASSAPEQUA NY
11758-5823
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-5407
  • Fax:
Mailing address:
  • Phone: 516-799-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9578
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number011654
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: