Healthcare Provider Details

I. General information

NPI: 1407855612
Provider Name (Legal Business Name): ROBERT MATTHEW GELFAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 YORK AVE
NEW YORK NY
10128-6828
US

IV. Provider business mailing address

1751 YORK AVE
NEW YORK NY
10128-6828
US

V. Phone/Fax

Practice location:
  • Phone: 212-879-3496
  • Fax: 212-879-3724
Mailing address:
  • Phone: 212-879-3496
  • Fax: 212-879-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number186949
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA09074900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: