Individual
GINA A WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 MALTESE DR, MIDDLETOWN, NY 10940-2141
(845) 342-4774
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2141
(845) 342-4774
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
346705
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07259410
MEDICAID
NY
Enumeration date
10/30/2014
Last updated
10/03/2022
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