Individual
JASON D GIBSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1847 MOTT AVE, FAR ROCKAWAY, NY 11691-4220
(646) 573-2787
Mailing address
1847 MOTT AVE, FAR ROCKAWAY, NY 11691-4220
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
07/27/2026
Last updated
07/27/2026
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