Individual
JENNIFER GILLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
104 W 40TH ST, NEW YORK, NY 10018-3617
(646) 930-4147
Mailing address
104 W 40TH ST, NEW YORK, NY 10018-3617
(646) 930-4147
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
518774
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404992
NY
Other
Enumeration date
07/17/2019
Last updated
10/02/2023
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