Organization Active NPI

Sandra Gilban MD PC

  • Primary Care Clinic/Center
  • New York, NY
National Provider Identifier
1205067774
Registry record updated Aug 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
206109 Issued in NY
Legal business name
SANDRA GILBAN MD PC
Practice address
911 Park Ave
New York, NY 10075-0385
Phone
(212) 288-7388
Fax
(212) 288-7735
NPI assigned
Aug 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandra Gilban, MDNPI 1316953177
Title
President
Phone
(917) 743-6838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 206109 NY Primary

Addresses

Primary practice location

911 Park Ave
New York, NY 10075-0385

Mailing address

125 E 87TH St Apt 4D
New York, NY 10128-1125
Phone (917) 743-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000007 NY Part B Supplier - Clinic/Group Practice 6103970512 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249171200000",
    "number": "1205067774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E 87TH ST APT 4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281125",
            "telephone_number": "917-743-6838",
            "fax_number": "212-288-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750385",
            "telephone_number": "212-288-7388",
            "fax_number": "212-288-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA GILBAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-02",
        "last_updated": "2009-08-02",
        "status": "A",
        "authorized_official_last_name": "GILBAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-743-6838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "206109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.