Individual
BEVERLY GENTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9715 64TH RD, REGO PARK, NY 11374-2250
(718) 459-5592
(718) 459-6047
Mailing address
2011 OCEAN AVE, APT.6C, BROOKLYN, NY 11230-6873
(646) 281-5653
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
579492
NY
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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