Provider Demographics
NPI:1922375849
Name:GILMAN, /C. MARGO (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:/C.
Middle Name:MARGO
Last Name:GILMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 ROUTE 245
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14544-9692
Mailing Address - Country:US
Mailing Address - Phone:585-554-4806
Mailing Address - Fax:585-554-6172
Practice Address - Street 1:149 ROUTE 245
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:NY
Practice Address - Zip Code:14544-9692
Practice Address - Country:US
Practice Address - Phone:585-554-4806
Practice Address - Fax:585-554-6172
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318984-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse