Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 161941 | NY |
NPI | 1023005568 |
---|---|
Provider Name | Michael P Gabris |
First Address | Syracuse, NY 13210-1892 |
Second Address | Syracuse, NY 13210-1892 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 12/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01072884 | (05) | NY |
B82329 | (02) |