Provider Demographics
NPI:1770012429
Name:GERBLICH, MICHAL (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MICHAL
Middle Name:
Last Name:GERBLICH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:MICHAL
Other - Middle Name:
Other - Last Name:MOSKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:31 GREENRIDGE AVE APT 1P
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1214
Mailing Address - Country:US
Mailing Address - Phone:914-723-8100
Mailing Address - Fax:914-989-1117
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-723-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020435363LA2200X
NYF345883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health