Individual
GARY CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 E 58TH ST, 25TH FL, NEW YORK, NY 10155-0002
(212) 223-2920
(212) 223-2390
Mailing address
150 E 58TH ST, 25TH FL, NEW YORK, NY 10155-0002
(212) 223-2920
(212) 223-2390
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401463-1
NY
Other
Enumeration date
05/20/2014
Last updated
05/21/2014
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