Provider Demographics
NPI:1679624993
Name:SERGEY GABINSKY MEDICAL PC
Entity type:Organization
Organization Name:SERGEY GABINSKY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GABINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-421-1200
Mailing Address - Street 1:22 COLERIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:229 PARKVILLE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1373
Practice Address - Country:US
Practice Address - Phone:718-421-1200
Practice Address - Fax:718-421-6573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199910174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2546746OtherAETNA HMO
NY26P1041OtherNY PRESYBETERIAN HOSPITAL
NYBK00045OtherMHS
NYP480275OtherOXFORD
NY199910-B79OtherHEALTH FIRST
NY7439819OtherHEALTH PLUS
NY01592790Medicaid
NY534731Medicaid
2602083OtherGHI
NYBK0004502OtherAMERICHOICE
NY4C6779OtherHEALTH NET
NY00-04421OtherNYH COMM
NY5227079OtherAETNA PPO
NY54094NOtherCIGNA
NY4C6779OtherHEALTH NET
NY2546746OtherAETNA HMO
NYG07047Medicare UPIN