MEDICARE: MICHAEL GARBULSKY PA

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	363A00000X	Physician Assistant	009431	NY

General Provider Information

NPI Number	:	1851461883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GARBULSKY PA

Provider Business Mailing Address
First Line	:	5223 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2913
Country	:	US
Telephone Number	:	718-431-2959
Fax Number	:	718-431-2974

Provider Business Practice Location Address
First Line	:	5223 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2913
Country	:	US
Telephone Number	:	718-431-2959
Fax Number	:	718-431-2974

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/22/2010

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