Provider Demographics
NPI:1538114780
Name:GILDERSLEEVE, ROBERT K
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:GILDERSLEEVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MANSFIELD OB/GYN ASSOCIATES
Mailing Address - Street 2:21 LEDGEBROOK DRIVE
Mailing Address - City:MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MANSFIELD OB/GYN ASSOCIATES
Practice Address - Street 2:21 LEDGEBROOK DRIVE
Practice Address - City:MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06205
Practice Address - Country:US
Practice Address - Phone:860-450-7227
Practice Address - Fax:860-450-7231
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037976207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology