Healthcare Provider Details

I. General information

NPI: 1124800933
Provider Name (Legal Business Name): TAFIA M GIBBS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAFIA M ROBINSON RN

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PENN PLZ
NEW YORK NY
10119-0002
US

IV. Provider business mailing address

70 SPENCER PL
HEMPSTEAD NY
11550-5819
US

V. Phone/Fax

Practice location:
  • Phone: 516-265-4432
  • Fax:
Mailing address:
  • Phone: 646-721-5864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF352870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: