Provider Demographics
NPI:1548931272
Name:GENTILE, NICHOLAS JOHN (PA-C)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:JOHN
Last Name:GENTILE
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:62 E 21ST ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1889
Mailing Address - Country:US
Mailing Address - Phone:603-401-0981
Mailing Address - Fax:
Practice Address - Street 1:333 E 38TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2772
Practice Address - Country:US
Practice Address - Phone:646-754-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2022-09-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant