Healthcare Provider Details

I. General information

NPI: 1407076342
Provider Name (Legal Business Name): RUBY ALEXANDRA GELMAN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 W 12TH ST SUITE 1F
NEW YORK NY
10011-8562
US

IV. Provider business mailing address

49 W 12TH ST SUITE 1F
NEW YORK NY
10011-8562
US

V. Phone/Fax

Practice location:
  • Phone: 212-682-9555
  • Fax:
Mailing address:
  • Phone: 212-682-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number047967
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: