Provider Demographics
NPI:1780347898
Name:GILL, NAVNEET (PA)
Entity type:Individual
Prefix:MRS
First Name:NAVNEET
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:NAVNEET
Other - Middle Name:
Other - Last Name:JAWANDHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 RESEARCH RD
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-2701
Mailing Address - Country:US
Mailing Address - Phone:631-751-3000
Mailing Address - Fax:
Practice Address - Street 1:4564 FRANCIS LEWIS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3085
Practice Address - Country:US
Practice Address - Phone:631-751-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027192363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant