Provider Demographics
NPI:1518638014
Name:GELBER, ANDREW JONATHAN (PTA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JONATHAN
Last Name:GELBER
Suffix:
Gender:M
Credentials:PTA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:854 W 181ST ST APT 1H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4401
Mailing Address - Country:US
Mailing Address - Phone:646-240-1259
Mailing Address - Fax:
Practice Address - Street 1:123 WEST 18TH STREET
Practice Address - Street 2:CELLAR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:646-678-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010652-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010652-1OtherTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT