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Individual

BRET TABACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
161 FORT WASHINGTON AVE FL 10, NEW YORK, NY 10032-3729
(212) 305-9676
(212) 305-1522
Mailing address
PO BOX 27036, NEW YORK, NY 10087-7036
(212) 305-9576
(212) 305-9480

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
237470
NY
2086X0206X
Surgical Oncology Physician
Primary
237470
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2701182
NY
Enumeration date
10/25/2006
Last updated
12/23/2024
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