Individual
GERVON R THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
198 E 121ST ST # 5, NEW YORK, NY 10035-3523
(212) 801-3300
Mailing address
1977 RALPH AVE STE B, BROOKLYN, NY 11234-5416
(718) 444-0092
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F406088-01
NY
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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