Individual
MS. INNA GEDZBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-2961
Mailing address
22 MALTESE DR, FAIR LAWN, NJ 07410-5812
(201) 475-9515
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004996
NY
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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