Provider Demographics
NPI:1508120213
Name:GESSIN, JULIE ZUCKERMAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ZUCKERMAN
Last Name:GESSIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:APPLETON
Other - Last Name:ZUCKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:156 WEST 56TH STREET
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-283-3000
Mailing Address - Fax:646-786-3997
Practice Address - Street 1:110 EAST 55TH STREET
Practice Address - Street 2:PENTHOUSE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-283-3000
Practice Address - Fax:646-786-3997
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015683363AM0700X, 363A00000X
MI5601006387363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical