Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 268684 | NY |
NPI | 1063677599 |
---|---|
Provider Name | Dr. Marc Gibber |
First Address | New York, NY 10024-3246 |
Second Address | Bronx, NY 10467-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 01/06/2021 |