Provider Demographics
NPI:1831124205
Name:GABRESKI, RALPH C (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:C
Last Name:GABRESKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:135 EAST 38TH ST
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504
Mailing Address - Country:US
Mailing Address - Phone:814-868-8661
Mailing Address - Fax:
Practice Address - Street 1:464 ALLEGHENY BLVD
Practice Address - Street 2:VENANGO COUNTY VA CLINIC
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-6259
Practice Address - Country:US
Practice Address - Phone:814-868-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD058061L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G28877Medicare UPIN