Provider Demographics
NPI:1417251018
Name:JEROME B GABRY MDPC
Entity Type:Organization
Organization Name:JEROME B GABRY MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:GABRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-5050
Mailing Address - Street 1:9801 GEORGIA AVE
Mailing Address - Street 2:SUITE # 221
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5276
Mailing Address - Country:US
Mailing Address - Phone:301-681-5050
Mailing Address - Fax:301-681-2630
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE # 221
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-681-5050
Practice Address - Fax:301-681-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD43931207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty