Provider Demographics
NPI:1225152465
Name:FERSZTMAN, GIDEON (ORTHODONTICS)
Entity Type:Individual
Prefix:DR
First Name:GIDEON
Middle Name:
Last Name:FERSZTMAN
Suffix:
Gender:M
Credentials:ORTHODONTICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 DICK ROAD
Mailing Address - Street 2:DR GAMBACORTA & DENTAL ASSOCIATES
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-3848
Mailing Address - Country:US
Mailing Address - Phone:716-684-8882
Mailing Address - Fax:716-651-0110
Practice Address - Street 1:750 DICK ROAD
Practice Address - Street 2:DR GAMBACORTA & DENTAL ASSOCIATES
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-3848
Practice Address - Country:US
Practice Address - Phone:716-684-8882
Practice Address - Fax:716-651-0110
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0518891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics