Provider Demographics
NPI:1710205380
Name:GILDA FERNANDEZ NAFARRETE,MD,PC
Entity Type:Organization
Organization Name:GILDA FERNANDEZ NAFARRETE,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:FERNANDEZ
Authorized Official - Last Name:NAFARRETE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-758-0888
Mailing Address - Street 1:3007 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4007
Mailing Address - Country:US
Mailing Address - Phone:718-758-0888
Mailing Address - Fax:
Practice Address - Street 1:2081 E 54TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4712
Practice Address - Country:US
Practice Address - Phone:718-758-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190418-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01452208Medicaid
NYF45390Medicare UPIN