Individual
GISELLE A JIMENEZ CACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 908-8249
Mailing address
258 HYLAN BLVD, STATEN ISLAND, NY 10305-2063
(347) 229-8811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA11670100
NJ
207Q00000X
Family Medicine Physician
Primary
317612
NY
Other
Enumeration date
03/27/2018
Last updated
06/26/2023
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