Provider Demographics
NPI:1215913983
Name:GAVE, ASAF A (MD)
Entity type:Individual
Prefix:
First Name:ASAF
Middle Name:A
Last Name:GAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-0188
Mailing Address - Country:US
Mailing Address - Phone:718-983-9530
Mailing Address - Fax:718-370-7141
Practice Address - Street 1:BIMC 1ST AVENUE & 16TH STREET
Practice Address - Street 2:3 SILVER RM 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-844-1026
Practice Address - Fax:212-844-1785
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA082030002086S0102X
NY2212532086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02654617Medicaid
NYI11496Medicare UPIN