Individual
MISS MARY KAY A GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 BEACH 105 STREET, 12F, ROCKAWAY PARK, NY 11694
(718) 318-8454
Mailing address
1 BEACH 105 STREET, 12F, ROCKAWAY PARK, NY 11694
(718) 318-8454
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
662160
NY
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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