Provider Demographics
NPI:1407817406
Name:GELLEN, JUDIT (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDIT
Middle Name:
Last Name:GELLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 43RD ST APT 1021
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4817
Mailing Address - Country:US
Mailing Address - Phone:646-228-9616
Mailing Address - Fax:
Practice Address - Street 1:265 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2458
Practice Address - Country:US
Practice Address - Phone:207-459-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160490207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01839183Medicaid
NY01839183Medicaid
NY36E631Medicare ID - Type Unspecified