Individual
VICTORIA GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
625 WHITNEY AVE APT 5, NEW HAVEN, CT 06511-2281
(860) 465-6011
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4392
CT
363AS0400X
Surgical Physician Assistant
4392
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/28/2018
Last updated
11/12/2019
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