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General NPI Number Information
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NPI Number | 1659768000
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Entity Type | Individual
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Provider Name | BERTILLE HERVEE AFIAVI GAIGBE-TOGBE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 865 NORTHERN BLVD STE 202
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City | GREAT NECK
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State | NY
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Zip | 11021-5310
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Country | US
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Telephone | 516-622-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 1176 5TH AVE # 1170
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City | NEW YORK
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State | NY
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Zip | 10029-6503
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Country | US
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Telephone | 212-241-8578
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Fax |
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 298093
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 298093
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License Number State | NY
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