Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 281024 | NY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 66359 | MN |
NPI | 1093944670 |
---|---|
Provider Name | Jonathan Gelber |
First Address | Rochester, MN 55904-6756 |
Second Address | Rochester, MN 55904-4717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2009 |
Last Update Date | 25/09/2019 |