Healthcare Provider Details

I. General information

NPI: 1609865492
Provider Name (Legal Business Name): CONSTANCE BELIN GIBB M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST ROOM P-695
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

525 E 68TH ST ROOM P-695
NEW YORK NY
10021-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3972
  • Fax: 212-746-8986
Mailing address:
  • Phone: 212-746-3972
  • Fax: 212-746-8986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: