Provider Demographics
NPI:1740245430
Name:GUNSBURG, MOSHE Y (MD)
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:Y
Last Name:GUNSBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKDALE PLAZA
Mailing Address - Street 2:BROOKDALE UNIVERSITY HOSPITAL AND MEDICAL CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3198
Mailing Address - Country:US
Mailing Address - Phone:718-240-6288
Mailing Address - Fax:718-240-6295
Practice Address - Street 1:1 BROOKDALE PLAZA
Practice Address - Street 2:BROOKDALE UNIVERSITY HOSPITAL AND MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3198
Practice Address - Country:US
Practice Address - Phone:718-240-6288
Practice Address - Fax:718-240-6295
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1608801207R00000X, 207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01131539Medicaid
D91849Medicare UPIN
NYW7E231Medicare ID - Type Unspecified