Individual
CARIN LIELA GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GUSTAVE L LEVY PL # 1149, NEW YORK, NY 10029-6504
(203) 913-9582
Mailing address
1827 2ND AVE APT 4S, NEW YORK, NY 10128-8504
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033317
NY
Other
Enumeration date
01/17/2025
Last updated
06/12/2025
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