NPI Profile for EZRA GILLEGO in NEW YORK, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| 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 |
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| Hospital affiliation(s) |
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EZRA GILLEGO
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