Healthcare Provider Details

I. General information

NPI: 1578501185
Provider Name (Legal Business Name): BRIAN DAVID GELBMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MADISON AVE
NEW YORK NY
10022-1009
US

IV. Provider business mailing address

635 MADISON AVE SUITE 1101
NEW YORK NY
10022-1009
US

V. Phone/Fax

Practice location:
  • Phone: 212-628-6611
  • Fax:
Mailing address:
  • Phone: 212-628-6611
  • Fax: 212-588-9897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number224664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: