Provider Demographics
NPI:1003107285
Name:YACOB, GABRIEL E (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:E
Last Name:YACOB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-332-3525
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1513
Practice Address - Country:US
Practice Address - Phone:716-701-1530
Practice Address - Fax:716-701-1535
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2023-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP5248207L00000X, 207LP2900X
NY260092-1207L00000X
NY260092207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology