Provider Demographics
NPI:1760769046
Name:GULLAS, CECILIA KILAYKO (RN)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:KILAYKO
Last Name:GULLAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 73RD ST
Mailing Address - Street 2:SUITE 3J
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3731 73RD ST
Practice Address - Street 2:SUITE 3J
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6250
Practice Address - Country:US
Practice Address - Phone:347-617-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY485480163W00000X, 163WA0400X, 163WA2000X, 163WC0200X, 163WC0400X, 163WC1400X, 163WC1500X, 163WC2100X, 163WC3500X, 163WD0400X, 163WD1100X, 163WE0003X, 163WE0900X, 163WF0300X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WF0300XNursing Service ProvidersRegistered NurseFlight
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care