Individual
MR. JEFFERSON G A GABALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
166 MADISON AVE, 3RD FLOOR, NEW YORK, NY 10016
(212) 687-5560
(212) 687-5530
Mailing address
PO BOX 15315, JERSEY CITY, NJ 07305
(201) 432-2865
(201) 915-1722
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
203423
NY
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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