Provider Demographics
NPI:1720531221
Name:STREETER, GINA RAIMONDI (PA)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:RAIMONDI
Last Name:STREETER
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE STE C893
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:914-886-5353
Mailing Address - Fax:
Practice Address - Street 1:440 MILE SQUARE RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6367
Practice Address - Country:US
Practice Address - Phone:914-886-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2023-02-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant