Provider Demographics
NPI:1548582018
Name:HALL-GENTILE, KIMBERLY GRACE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:GRACE
Last Name:HALL-GENTILE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:GRACE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3100
Mailing Address - Fax:914-682-6588
Practice Address - Street 1:210 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2901
Practice Address - Country:US
Practice Address - Phone:914-681-3100
Practice Address - Fax:914-682-6588
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335315-1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care