Provider Demographics
NPI:1295844819
Name:GILO, JANINA M (APRN)
Entity Type:Individual
Prefix:
First Name:JANINA
Middle Name:M
Last Name:GILO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANINA
Other - Middle Name:M
Other - Last Name:GILO TOMKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 208064
Mailing Address - Street 2:YALE UNIVERSITY, DEPT OF PEDIATRICS, SECT OF IMMUNOLOGY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8064
Mailing Address - Country:US
Mailing Address - Phone:203-785-4081
Mailing Address - Fax:203-737-5972
Practice Address - Street 1:1 LONG WHARF DR
Practice Address - Street 2:SUITE 210, YALE PEDIATRIC ALLERGY & IMMUNOLOGY
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-785-4081
Practice Address - Fax:203-737-5972
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004235900Medicaid
CT004235900Medicaid