Provider Demographics
NPI:1942074307
Name:GILEAU, ABUMAEL
Entity Type:Individual
Prefix:
First Name:ABUMAEL
Middle Name:
Last Name:GILEAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E 14TH ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5930
Mailing Address - Country:US
Mailing Address - Phone:134-764-7702
Mailing Address - Fax:
Practice Address - Street 1:1322 E 14TH ST APT 2D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5930
Practice Address - Country:US
Practice Address - Phone:134-764-7702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001813-P.A.207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine