Individual
MR. MICHAEL JOSEPH GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
12 SCENIC HILLS DR, RIDGE, NY 11961-3022
(631) 775-9317
Mailing address
12 SCENIC HILLS DR, RIDGE, NY 11961-3022
(631) 775-9317
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4501131
NY
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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