Healthcare Provider Details

I. General information

NPI: 1467839423
Provider Name (Legal Business Name): GILLIAN TAORMINA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010
US

IV. Provider business mailing address

3460 14TH ST NW APT 19
WASHINGTON DC
20010-3492
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7000
  • Fax:
Mailing address:
  • Phone: 518-859-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO034732
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: