Provider Demographics
NPI:1689645079
Name:MAKABALI, GILBERT G (MD)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:G
Last Name:MAKABALI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1471 BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1604
Mailing Address - Country:US
Mailing Address - Phone:516-569-2828
Mailing Address - Fax:516-295-4145
Practice Address - Street 1:271 DOUGHTY BLVD
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:NY
Practice Address - Zip Code:11096-2135
Practice Address - Country:US
Practice Address - Phone:516-569-2828
Practice Address - Fax:516-295-4145
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY115251208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00212051Medicaid
NY951301Medicare PIN
NYB20334Medicare UPIN
NY36786GMedicare PIN
NY6514WVMedicare PIN