Provider Demographics
NPI:1134236961
Name:GELIN, EMMANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:
Last Name:GELIN
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 1:15131 81ST ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1735
Mailing Address - Country:US
Mailing Address - Phone:516-567-2273
Mailing Address - Fax:718-240-0564
Practice Address - Street 1:15131 81ST ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1735
Practice Address - Country:US
Practice Address - Phone:516-567-2273
Practice Address - Fax:718-240-0564
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG08498Medicare UPIN