Individual
FUSEINA GIMBALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 263-2085
Mailing address
32 KATHWOOD RD, WHITE PLAINS, NY 10607-1158
(462) 867-6456
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/20/2023
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