Healthcare Provider Details

I. General information

NPI: 1215913983
Provider Name (Legal Business Name): ASAF A GAVE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BIMC 1ST AVENUE & 16TH STREET 3 SILVER RM 1
NEW YORK NY
10003
US

IV. Provider business mailing address

PO BOX 188
MARLBORO NJ
07746-0188
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-1026
  • Fax: 212-844-1785
Mailing address:
  • Phone: 718-983-9530
  • Fax: 718-370-7141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number25MA08203000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number221253
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: