Provider Demographics
NPI:1427390475
Name:CLIMACO, GISELLE E (LPN)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:E
Last Name:CLIMACO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:GISELLE
Other - Middle Name:E
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:56 KENT LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 KENT LAKE AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3053
Practice Address - Country:US
Practice Address - Phone:845-282-4078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-17
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299925164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse