Individual
MS. AMY RAE GIBOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1 KING ST, BELFAST, NY 14711-8682
(585) 365-2646
(585) 365-2648
Mailing address
1 KING ST, BELFAST, NY 14711-8682
(585) 365-2646
(585) 365-2648
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
266865-1
NY
251300000X
Local Education Agency (LEA)
Primary
672036
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01377191
—
NY
Enumeration date
09/09/2010
Last updated
03/17/2018
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