Provider Demographics
NPI:1851838866
Name:GATHRIGHT, GARY (NP)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:GATHRIGHT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BUSTLETON PIKE STE 7
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4108
Mailing Address - Country:US
Mailing Address - Phone:267-288-5060
Mailing Address - Fax:267-288-5059
Practice Address - Street 1:1200 BUSTLETON PIKE STE 7
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4108
Practice Address - Country:US
Practice Address - Phone:267-288-5060
Practice Address - Fax:267-288-5059
Is Sole Proprietor?:No
Enumeration Date:2017-01-28
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily