Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 128127 | NY |
NPI | 1013901230 |
---|---|
Provider Name | Bernard Gelbard |
First Address | East Syracuse, NY 13057-4505 |
Second Address | Malone, NY 12953-1220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 30/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B71780 | (02) |