Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 160737 | NY |
Y | 207RP1001X | Pulmonary Disease | 160737 | NY |
NPI | 1043267610 |
---|---|
Provider Name | Dr. Eugene Gibilaro |
First Address | Brooklyn, NY 11209-4342 |
Second Address | Brooklyn, NY 11209-3447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 02/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01077783 | NYS MEDICAID (01) | NY |
13E431 | EMPIRE BLUE CROSS (01) | NY |
A60661 | (02) | NY |