Healthcare Provider Details

I. General information

NPI: 1609770643
Provider Name (Legal Business Name): THALIA S GIL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 392
FLEISCHMANNS NY
12430-0392
US

IV. Provider business mailing address

PO BOX 392
FLEISCHMANNS NY
12430-0392
US

V. Phone/Fax

Practice location:
  • Phone: 845-303-4849
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number354926
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: