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General NPI Number Information
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NPI Number | 1689757072
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Entity Type | Individual
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Provider Name | RONALD M GUBERMAN DPM
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 135 MAMARONECK AVE
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City | MAMARONECK
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State | NY
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Zip | 10543-3712
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Country | US
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Telephone | 914-381-4440
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Fax | 718-497-7322
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Provider Business Mailing Address
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Address Line | 6083 MYRTLE AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5908
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Country | US
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Telephone | 718-381-8402
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Fax | 718-497-7322
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N004232
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License Number State | NY
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