Individual
CARL HENRY JEAN GILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9507 GLENWOOD RD, BROOKLYN, NY 11236-3459
(347) 893-6309
Mailing address
9507 GLENWOOD RD, BROOKLYN, NY 11236-3459
(347) 893-6309
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
678908-1
NY
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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