Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | 4717 | NY |
NPI | 1619161767 |
---|---|
Provider Name | Mr. Tibor Gelb |
First Address | Brooklyn, NY 11211-7907 |
Second Address | Brooklyn, NY 11211-7907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 30/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00426802 | (05) | NY |