Provider Demographics
NPI:1780767004
Name:GAMBITO, ERLINDA (MD)
Entity type:Individual
Prefix:
First Name:ERLINDA
Middle Name:
Last Name:GAMBITO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MEDICAL VILLAGE DRIVE
Mailing Address - Street 2:#258 INDEPENDENT ANESTHESIOLOGISTS PSC
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017
Mailing Address - Country:US
Mailing Address - Phone:859-341-7246
Mailing Address - Fax:859-341-7867
Practice Address - Street 1:20 MEDICAL VILLAGE DRIVE
Practice Address - Street 2:#258 INDEPENDENT ANESTHESIOLOGISTS PSC
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-341-7246
Practice Address - Fax:859-341-7867
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18325207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000032575OtherANTHEM - BLUE SHIELD
OH0539297Medicaid
076444482200OtherBUREAU-WORKERS COMP
KY64183254Medicaid
OH0539297Medicaid
KY64183254Medicaid