Individual
DR. RAFFAELE A GIBILISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PA
Contact information
Practice address
435 59TH ST, 1ST FLOOR, WEST NEW YORK, NJ 07093-2107
(201) 295-1456
(201) 295-0266
Mailing address
PO BOX 4067, WARREN, NJ 07059-0067
(201) 295-1456
(201) 295-0266
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA060124
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6057608
—
NJ
Enumeration date
08/22/2006
Last updated
07/14/2015
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