Provider Demographics
NPI:1417075458
Name:TAUB, GABRIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:TAUB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 BROADWAY MALL
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2709
Mailing Address - Country:US
Mailing Address - Phone:516-528-0173
Mailing Address - Fax:516-938-8667
Practice Address - Street 1:371 BROADWAY MALL
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2709
Practice Address - Country:US
Practice Address - Phone:516-938-0055
Practice Address - Fax:516-938-8667
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005761152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist