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General NPI Number Information
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NPI Number | 1427082932
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Entity Type | Organization
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Legal Business Name | MICHAEL E. GRIBETZ, MD PC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 1155 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10128-1209
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Country | US
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Telephone | 212-831-1300
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Fax | 212-860-7884
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Provider Business Mailing Address
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Address Line | 1155 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-831-1300
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Fax | 212-860-7884
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL E GRIBETZ
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Credential | MD
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Telephone | 212-831-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 120663
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License Number State | NY
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