Individual
LARRY R GITELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADVANCED RN PRACT
Contact information
Practice address
310 AMERICAN WAY STE A, WEIRTON, WV 26062-4083
(304) 797-6410
(304) 797-6320
Mailing address
PO BOX 6230, WHEELING, WV 26003-0722
(304) 242-7106
(304) 242-7108
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
VP005783L
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN59184
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102381000
—
WV
Enumeration date
02/28/2006
Last updated
11/15/2022
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