Provider Demographics
NPI:1326302936
Name:GAMBA, ESPERANZA
Entity Type:Individual
Prefix:
First Name:ESPERANZA
Middle Name:
Last Name:GAMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 92ND ST
Mailing Address - Street 2:APT # 2C
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1851
Mailing Address - Country:US
Mailing Address - Phone:718-505-4517
Mailing Address - Fax:
Practice Address - Street 1:3345 92ND ST
Practice Address - Street 2:APT # 2C
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1851
Practice Address - Country:US
Practice Address - Phone:718-505-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist