Individual
MR. BRENT ANTHONY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
425 ROBINSON ST, BINGHAMTON, NY 13904-1775
(607) 773-4044
Mailing address
425 ROBINSON ST, BINGHAMTON, NY 13904-1775
(607) 773-4044
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
649154-1
NY
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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