Individual
E. BROOKE GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 WEST AVE STE 330, SARATOGA SPRINGS, NY 12866-6065
(518) 584-5330
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004485
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473038
—
NY
05
—
02808735
—
NY
Enumeration date
09/20/2006
Last updated
05/21/2021
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