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General NPI Number Information
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NPI Number | 1023264926
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Entity Type | Organization
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Legal Business Name | GERALD J. SMALLBERG, M.D. P.C.
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 1010 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0130
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Country | US
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Telephone | 212-535-5348
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Fax | 212-535-6406
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Provider Business Mailing Address
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Address Line | 1010 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0130
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Country | US
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Telephone | 212-535-5348
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Fax | 212-535-6406
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD SMALLBERG
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Credential | M.D.
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Telephone | 212-535-5348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 123788
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License Number State | NY
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