Individual
THERESA A GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
515 MADISON AVE FRNT 5, NEW YORK, NY 10022-5488
(646) 888-1936
(646) 888-1910
Mailing address
515 MADISON AVE FRNT 5, NEW YORK, NY 10022-5488
(646) 888-1936
(646) 888-1910
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
25MA10013000
NJ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
82409197
NY
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
25MA10013000
NJ
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
82409197
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
25MA10013000
NJ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
82409197
NY
Other
Enumeration date
01/19/2006
Last updated
12/19/2018
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