Individual
DR. GABRIELLE BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15 N BROADWAY, 2ND FLOOR, WHITE PLAINS, NY 10601-2214
(914) 428-6000
(914) 593-7881
Mailing address
PO BOX 28064, NEW YORK, NY 10087-8064
(914) 593-7880
(914) 593-7881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
119650
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01120736
—
NY
01
—
110227809
RAIL ROAD MEDICARE
NY
01
—
18G763K223
PTAN
NY
Enumeration date
02/15/2006
Last updated
10/20/2015
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