Basic Information
Provider Information
NPI: 1609916105
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GERBER
FirstName: DMITRY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 WESTCHESTER AVE STE N715
Address2:  
City: RYE BROOK
State: NY
PostalCode: 105731369
CountryCode: US
TelephoneNumber: 9146075730
FaxNumber:  
Practice Location
Address1: 1084 N BROADWAY
Address2:  
City: YONKERS
State: NY
PostalCode: 107011107
CountryCode: US
TelephoneNumber: 9148488640
FaxNumber: 9148488641
Other Information
ProviderEnumerationDate: 02/07/2007
LastUpdateDate: 11/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X219853NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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