Healthcare Provider Details

I. General information

NPI: 1407012305
Provider Name (Legal Business Name): DAVID BRIAN GELBUDA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 W 43RD ST APT 15H
NEW YORK NY
10036-4312
US

IV. Provider business mailing address

560 W 43RD ST APT 15H
NEW YORK NY
10036-4312
US

V. Phone/Fax

Practice location:
  • Phone: 917-327-1445
  • Fax:
Mailing address:
  • Phone: 917-327-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX011564
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: