Provider Demographics
NPI:1417181165
Name:GIL, JEFFREY (RN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GIL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JULIA CIR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8299
Mailing Address - Country:US
Mailing Address - Phone:347-672-8777
Mailing Address - Fax:631-348-0154
Practice Address - Street 1:10 JULIA CIR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-8299
Practice Address - Country:US
Practice Address - Phone:347-672-8777
Practice Address - Fax:631-348-0154
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY452735-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse