Provider Demographics
NPI:1518075662
Name:GILBERT, MARVIN S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:S
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:57 WEST 57TH STREET
Mailing Address - Street 2:15TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2832
Mailing Address - Country:US
Mailing Address - Phone:212-289-0700
Mailing Address - Fax:212-289-0171
Practice Address - Street 1:57 WEST 57TH STREET
Practice Address - Street 2:15TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2832
Practice Address - Country:US
Practice Address - Phone:212-289-0700
Practice Address - Fax:212-289-0171
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0957791207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY536611Medicare ID - Type Unspecified
NY1518075662Medicare PIN