Provider Demographics
NPI:1841777489
Name:GASKIN, EMILE DUANE (RN)
Entity Type:Individual
Prefix:
First Name:EMILE
Middle Name:DUANE
Last Name:GASKIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11924 147TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11436-1528
Mailing Address - Country:US
Mailing Address - Phone:718-659-4340
Mailing Address - Fax:
Practice Address - Street 1:11924 147TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11436-1528
Practice Address - Country:US
Practice Address - Phone:718-659-4340
Practice Address - Fax:718-659-4340
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY567212163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse