Individual
DR. GABRIEL GUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3769 80TH ST FL 2, JACKSON HEIGHTS, NY 11372-6830
(718) 478-0338
(718) 673-6107
Mailing address
245 NORTH MAIN STREET STE 417, NEW CITY, NY 10956-0417
(718) 478-0338
(718) 478-6050
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
213265
NY
207R00000X
Internal Medicine Physician
Primary
213265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01947557
—
NY
Enumeration date
07/02/2006
Last updated
12/04/2023
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