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General NPI Number Information
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NPI Number | 1386758696
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Entity Type | Individual
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Provider Name | GERALD J SMALLBERG MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1010 FIFTH AVENUE
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City | NEW YORK
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State | NY
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Zip | 10028
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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 FIFTH AVENUE
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City | NEW YORK
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State | NY
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Zip | 10028
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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 |
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Name |
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Credential |
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Telephone |
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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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