Healthcare Provider Details

I. General information

NPI: 1790755437
Provider Name (Legal Business Name): GABAY ENT & ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 ROOSEVELT BLVD
PHILA PA
19115
US

IV. Provider business mailing address

9500 ROOSEVELT BLVD
PHILA PA
19115
US

V. Phone/Fax

Practice location:
  • Phone: 215-969-5650
  • Fax: 215-969-5651
Mailing address:
  • Phone: 215-969-5650
  • Fax: 215-969-5651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RAPHAEL GABAY
Title or Position: OWNER
Credential: DO
Phone: 215-969-5650