Provider Demographics
NPI:1801696489
Name:TRAVIESO, GHISLAINE
Entity type:Individual
Prefix:
First Name:GHISLAINE
Middle Name:
Last Name:TRAVIESO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 PALISADE AVE BLDG 8
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1537
Mailing Address - Country:US
Mailing Address - Phone:914-325-8313
Mailing Address - Fax:
Practice Address - Street 1:836 PALISADE AVE BLDG 8
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1537
Practice Address - Country:US
Practice Address - Phone:914-325-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY590277163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse