Provider Demographics
NPI:1952489098
Name:DABBS, EDWIN GERALD (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:GERALD
Last Name:DABBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 E 87TH ST APT 14E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1128
Mailing Address - Country:US
Mailing Address - Phone:212-534-1565
Mailing Address - Fax:212-534-5220
Practice Address - Street 1:125 E 87TH ST APT 14E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1128
Practice Address - Country:US
Practice Address - Phone:212-534-1565
Practice Address - Fax:212-534-5220
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1026352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD34160Medicare UPIN
NY678771Medicare ID - Type Unspecified