MEDICARE: DR. GABRIEL THOMAS BEDARD MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	2026026760	MO

General Provider Information

NPI Number	:	1548100043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL THOMAS BEDARD MD, PHD

Provider Business Mailing Address
First Line	:	1300 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1900
Country	:	US
Telephone Number	:	718-430-2129
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	06/15/2026

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