MEDICARE: DR. NANCY S GILSTON AU.D. CCCA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	H000020009	NY
2	231H00000X	Audiologist	1078	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P2671099	OTHER		OXFORD

General Provider Information

NPI Number	:	1962571893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY S GILSTON AU.D. CCCA

Provider Business Mailing Address
First Line	:	1356 MADISON AVE
Second Line	:	APT 1 SOUTH
City	:	NEW YORK
State	:	NY
Zip	:	10128-0826
Country	:	US
Telephone Number	:	917-821-5014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 PARK AVE STE 1A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1211
Country	:	US
Telephone Number	:	917-821-5014
Fax Number	:	212-996-2703

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	11/17/2020

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