Healthcare Provider Details

I. General information

NPI: 1730914060
Provider Name (Legal Business Name): GABBI HEALTH MEDICAL GROUP OF NEW JERSEY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MADISON AVE 5 AND 6 FLOOR
NEW YORK NY
10016
US

IV. Provider business mailing address

10350 N VANCOUVER WAY # 1067
PORTLAND OR
97217-7530
US

V. Phone/Fax

Practice location:
  • Phone: 805-286-7235
  • Fax:
Mailing address:
  • Phone: 805-286-7235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA GRITZFELD
Title or Position: OPERATIONS
Credential:
Phone: 503-482-8374