Provider Demographics
NPI:1659300523
Name:GILBOA, DEBORAH RUTH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RUTH
Last Name:GILBOA
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 1:4516 BROWNS HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2917
Mailing Address - Country:US
Mailing Address - Phone:412-422-7442
Mailing Address - Fax:412-904-5025
Practice Address - Street 1:4516 BROWNS HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2917
Practice Address - Country:US
Practice Address - Phone:412-422-7442
Practice Address - Fax:412-904-5025
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD419966Medicaid
PAH89527Medicare UPIN
PA071519REVMedicare ID - Type Unspecified