Healthcare Provider Details

I. General information

NPI: 1780861054
Provider Name (Legal Business Name): BRUCE ELLIOT GELB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 E 34TH ST 2ND FLOOR
NEW YORK NY
10016-4972
US

IV. Provider business mailing address

403 E 34TH ST
NEW YORK NY
10016-4972
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-8134
  • Fax:
Mailing address:
  • Phone: 212-263-8134
  • Fax: 212-263-8157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number242945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: