Provider Demographics
NPI: | 1730914060 |
---|---|
Name: | GABBI HEALTH MEDICAL GROUP OF NEW JERSEY, PC |
Entity type: | Organization |
Organization Name: | GABBI HEALTH MEDICAL GROUP OF NEW JERSEY, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OPERATIONS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMANDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GRITZFELD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 503-482-8374 |
Mailing Address - Street 1: | 10350 N VANCOUVER WAY # 1067 |
Mailing Address - Street 2: | |
Mailing Address - City: | PORTLAND |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97217-7530 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 805-286-7235 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 136 MADISON AVE |
Practice Address - Street 2: | 5 AND 6 FLOOR |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10016 |
Practice Address - Country: | US |
Practice Address - Phone: | 805-286-7235 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-09-05 |
Last Update Date: | 2024-09-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207VX0201X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | Group - Single Specialty |