Individual
GILA HENESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
923 BROADWAY, WOODMERE, NY 11598-1739
(516) 239-1800
(516) 295-5557
Mailing address
107 HARRISON ST, LAWRENCE, NY 11559-1931
(516) 761-0364
(516) 295-5557
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007070-01
NY
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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