MEDICARE: GILEAD ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W20623088	OTHER	MD	MARYLAND DEPARTMENT OF TAXATION-SDAT

General Provider Information

NPI Number	:	1295342772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILEAD ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	206 MULBERRY RIDGE CT
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-7514
Country	:	US
Telephone Number	:	432-038-0944
Fax Number	:

Provider Business Practice Location Address
First Line	:	7661 ARUNDEL MILLS BLVD
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-1305
Country	:	US
Telephone Number	:	672-250-6736
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	GBEMISOLA ELIZABETH MOJELOPE
Credential	:	PMHNP-BC
Telephone Number	:	667-225-0673

Provider Enumeration Date	:	09/28/2020
Last Update Date	:	09/08/2023

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Directions to “GILEAD ASSOCIATES LLC ” Practice Location

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