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Contact Information

EZRA GILLEGO, RPA-C
1ST AVE 16TH STREET
NEW YORK, NY10003
 Phone: 212-420-2953
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for EZRA GILLEGO · (Male)

NPI # 1407061393
Status Active
Credentials RPA-C
Entity Individual
Enumeration date 05/13/2007
Last updated 03/11/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 011163
Hospital affiliation(s)
  • SOUTH NASSAU COMMUNITIES HOSPITAL - (Acute Care)
    ONE HEALTHY WAY
    OCEANSIDE, NY 11572
  • ST FRANCIS HOSPITAL ROSLYN - (Acute Care)
    100 PORT WASHINGTON BOULEVARD
    ROSLYN, NY 11576
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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