Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 260493 | NY |
Y | 2080P0204X | Pediatric Emergency Doctor | 260493 | NY |
NPI | 1285909630 |
---|---|
Provider Name | Dr. Michelle Gaba |
First Address | New York, NY 10003 |
Second Address | New York, NY 10003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2012 |
Last Update Date | 23/07/2019 |