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Individual

GLADSTONE L GUNISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A

Contact information

Practice address
629 W 185TH ST, NEW YORK, NY 10033-3102
(212) 928-3900
(212) 795-0470
Mailing address
629 W 185TH ST, NEW YORK, NY 10033-3102
(212) 928-3900
(212) 795-0470

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002809-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013040030
NY
Enumeration date
03/11/2009
Last updated
03/11/2009
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