Provider Demographics
NPI:1790755437
Name:GABAY ENT & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:GABAY ENT & ASSOCIATES, INC.
Other - Org Name:GABAY SCHARTZ ENTY ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GABAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-969-5650
Mailing Address - Street 1:9500 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19115
Mailing Address - Country:US
Mailing Address - Phone:215-969-5650
Mailing Address - Fax:215-969-5651
Practice Address - Street 1:9500 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19115
Practice Address - Country:US
Practice Address - Phone:215-969-5650
Practice Address - Fax:215-969-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001396924000YMedicaid
PA001396924000YMedicaid