Provider Demographics
NPI:1316979453
Name:GABINSKAYA, TATYANA (MD)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:GABINSKAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2378 RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5515
Mailing Address - Country:US
Mailing Address - Phone:718-531-6660
Mailing Address - Fax:718-531-6662
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:ROOMM A1-9
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-4952
Practice Address - Fax:718-334-4815
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203607208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01952405Medicaid
NYG98725Medicare UPIN
NY01952405Medicaid