Provider Demographics
NPI:1841289063
Name:GERBER, SANFORD NEAL (DDS)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:NEAL
Last Name:GERBER
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 1:1561 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2365
Mailing Address - Country:US
Mailing Address - Phone:516-775-1212
Mailing Address - Fax:516-775-6500
Practice Address - Street 1:1561 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2365
Practice Address - Country:US
Practice Address - Phone:516-775-1212
Practice Address - Fax:516-775-6500
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0326351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00282068Medicaid