Organization
NURSE PRACTITIONER IN ADULT GERONTOLOGY FAMILY AND PALLATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE ZETILIA GABRIEL NP (MEMBER)
(917) 915-2866
Entity
Organization
Contact information
Practice address
100 WEST KINDSBRIDGE ROAD, BRONX, NY 10468-0355
(917) 915-2866
Mailing address
169 S MAIN ST, NEW CITY, NY 10956-3353
(917) 915-2866
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356367569
—
NY
Enumeration date
04/21/2021
Last updated
04/21/2021
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