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General NPI Number Information
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NPI Number | 1376929695
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Entity Type | Organization
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Legal Business Name | G & B HEALTHCARE MEDICAL PLLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 9108 ELMHURST AVE
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City | JACKSON HTS
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State | NY
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Zip | 11372-7937
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Country | US
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Telephone | 718-672-2451
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Fax | 718-672-2581
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Provider Business Mailing Address
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Address Line | 9108 ELMHURST AVE
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City | JACKSON HTS
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State | NY
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Zip | 11372-7937
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Country | US
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Telephone | 718-672-2451
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Fax | 718-672-2581
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN SABIDO
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Credential | MD
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Telephone | 718-672-2451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 230917-1
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License Number State | NY
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