Individual
MS. CLEMENCIA GIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 WEDGEWOOD DR, GOSHEN, NY 10924-2539
(845) 572-8001
Mailing address
4 WEDGEWOOD DR, GOSHEN, NY 10924-2539
(845) 572-8001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14297446
HIP PRIME
NY
Enumeration date
11/28/2012
Last updated
11/28/2012
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