Individual provider · Type 1 NPI
Jefferson G. A. Gaballa, MD
General Practice Physician · New York, NY
NPI number
1609065580
Active
Practice location
166 Madison Ave, 3rd Floor
New York, NY 10016
Fax (212) 687-5530
Mailing address
PO Box 15315
Jersey City, NJ 07305
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 203423 (NY) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1609065580
Jefferson G. A. Gaballa, MD's National Provider Identifier is 1609065580, issued on Oct 17, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in New York, NY. The record was last updated on Oct 17, 2007.