Provider Demographics
NPI:1396897484
Name:GABOW, PETER R (DDS)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:R
Last Name:GABOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 THEODORE FREMD AVE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2932
Mailing Address - Country:US
Mailing Address - Phone:914-967-4355
Mailing Address - Fax:914-967-4388
Practice Address - Street 1:45 THEODORE FREMD AVE
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2932
Practice Address - Country:US
Practice Address - Phone:914-967-4355
Practice Address - Fax:914-967-4388
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist