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Individual
GLORIA PAK
Active
Individual
GLORIA PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
713794
NY
163W00000X
Registered Nurse
R270128
MD
363LP0200X
Pediatric Nurse Practitioner
382836
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
R270128
MD
Other
Enumeration date
06/27/2017
Last updated
02/18/2025
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