Provider Information for 1629142880
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AMY IPP GELB
Sex: Female
NPI: 1629142880
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
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NPI | 1629142880 | ||||||||
Enumeration Date | 2006-11-20 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 98 120 QUEENS BLVD APT 1C REGO PARK, NY 11374 United States Phone: | Fax: | ||||||||
Primary Practice Address | 98 120 QUEENS BLVD APT 1C REGO PARK, NY 11374 United States Phone: 718-838-0246 | Fax: | ||||||||
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