Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 347231 | NY |
Y | 213EG0000X | General Practice | 347231 | NY |
NPI | 1003022195 |
---|---|
Provider Name | Mark Scott Gilbert |
First Address | Brooklyn, NY 11230 |
Second Address | Brooklyn, NY 11230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00682637 | (05) | NY |