Healthcare Provider Details

I. General information

NPI: 1881814929
Provider Name (Legal Business Name): ORA ELLEN GELB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 MAIN STREET SUITE H 2
MOUNT KISCO NY
10549
US

IV. Provider business mailing address

153 MAIN STREET SUITE H 2
MOUNT KISCO NY
10549
US

V. Phone/Fax

Practice location:
  • Phone: 914-234-9077
  • Fax:
Mailing address:
  • Phone: 914-234-9077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number187826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: