Provider Demographics
NPI:1275508954
Name:GELBFISH, GARY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:GELBFISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2830
Mailing Address - Country:US
Mailing Address - Phone:718-258-3004
Mailing Address - Fax:718-421-8168
Practice Address - Street 1:2502 AVENUE I
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2830
Practice Address - Country:US
Practice Address - Phone:718-258-3004
Practice Address - Fax:718-421-8168
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16340612086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01161839Medicaid
NY01161839Medicaid
NY32F352Medicare PIN