Provider Demographics
NPI:1376537134
Name:SAPHIRE, GARY S (DPM)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:S
Last Name:SAPHIRE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 AVENUE P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4934
Mailing Address - Country:US
Mailing Address - Phone:718-236-5253
Mailing Address - Fax:718-331-6720
Practice Address - Street 1:248 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4934
Practice Address - Country:US
Practice Address - Phone:718-236-5253
Practice Address - Fax:718-331-6720
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002873213ES0103X
NYNOO2873213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0047935OtherGHI
NY4C7788OtherHEALTH NET
NMKS889OtherMEDICARE ADVANTAGE
NYP89992OtherEMPIRE BLUE CROSS BLUE SH
NY004228473OtherAETNA
NY0528724006OtherCIGNA
NY2306889OtherUS HEALTH CARE
NY00415334Medicaid
NY263150101OtherHEALTH PLUS
NYKS889OtherOXFORD
NYSP6927OtherCENTERCARE
NY112504358OtherMETROPOLITAN LIFE
NY25272OtherUNITED HEALTH CARE
NY000000055293OtherGHI HMO SELECT
NY0000067486OtherLOCAL 285
NY0528724006OtherCIGNA
NYP89992OtherEMPIRE BLUE CROSS BLUE SH
NY4C7788OtherHEALTH NET