Provider Demographics
NPI:1295246726
Name:GAENGAN, JULIET GAWE (RN)
Entity type:Individual
Prefix:MS
First Name:JULIET
Middle Name:GAWE
Last Name:GAENGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:JULIET
Other - Middle Name:BESWAYAN
Other - Last Name:GAWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:70 PARK TER E APT 2J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1410
Mailing Address - Country:US
Mailing Address - Phone:917-375-8190
Mailing Address - Fax:
Practice Address - Street 1:70 PARK TER E APT 2J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1410
Practice Address - Country:US
Practice Address - Phone:917-375-8190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY364784163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse