Individual
JAMES GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1290 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4337
(860) 972-9033
Mailing address
36 WOODVALE AVE, KINGS PARK, NY 11754-1028
(631) 456-3835
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019387
NY
Other
Enumeration date
01/12/2016
Last updated
07/12/2023
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