Provider Demographics
NPI:1285015099
Name:GORBAL, MAYYA (DO)
Entity type:Individual
Prefix:
First Name:MAYYA
Middle Name:
Last Name:GORBAL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:MAYYA
Other - Middle Name:
Other - Last Name:GLEYZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2517
Mailing Address - Country:US
Mailing Address - Phone:347-522-3320
Mailing Address - Fax:
Practice Address - Street 1:348 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4221
Practice Address - Country:US
Practice Address - Phone:347-522-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295999208100000X
NJ25MB10968600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation