Provider Demographics
NPI:1154420982
Name:GILBERT, MARTI (DO)
Entity type:Individual
Prefix:
First Name:MARTI
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 HEMPSTEAD TPKE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3641
Mailing Address - Country:US
Mailing Address - Phone:516-233-2882
Mailing Address - Fax:516-270-3229
Practice Address - Street 1:925 HEMPSTEAD TPKE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3641
Practice Address - Country:US
Practice Address - Phone:516-233-2882
Practice Address - Fax:516-270-3229
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219471207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I35056Medicare UPIN
NY788031Medicare Oscar/Certification