Provider Demographics
NPI:1306834692
Name:GELFAND, JANICE M (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:GELFAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WATERS PL
Mailing Address - Street 2:SUITE M104
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2728
Mailing Address - Country:US
Mailing Address - Phone:347-810-7201
Mailing Address - Fax:718-794-1222
Practice Address - Street 1:1200 WATERS PL
Practice Address - Street 2:SUITE M104
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2728
Practice Address - Country:US
Practice Address - Phone:347-810-7201
Practice Address - Fax:718-794-1222
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2012-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY146926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00908021Medicaid
NY00908021Medicaid
C10596Medicare UPIN