Individual provider Active NPI

Howard Eliot Gilman, M.D.

  • Psychiatry Physician
  • Ridgewood, NJ
National Provider Identifier
1669492229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA05094900 Issued in NJ
Practice address
1172 E Ridgewood Ave
Suite #7
Ridgewood, NJ 07450-3936
Phone
(201) 612-6050
Fax
(201) 612-0422
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA05094900 NJ Primary
Psychiatry Physician 2084P0800X 138479 NY

Addresses

Primary practice location

1172 E Ridgewood Ave
Suite #7
Ridgewood, NJ 07450-3936

Mailing address

PO Box 1227
Ridgewood, NJ 07451-1227
Phone (201) 612-6050

Other identifiers 1

IdentifierTypeStateIssuer
0221503MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
138479NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669492229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1227",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074511227",
            "telephone_number": "201-612-6050",
            "fax_number": "201-612-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 E RIDGEWOOD AVE",
            "address_2": "SUITE #7",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503936",
            "telephone_number": "201-612-6050",
            "fax_number": "201-612-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "HOWARD",
        "middle_name": "ELIOT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA05094900",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "138479",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0221503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.