Healthcare Provider Details

I. General information

NPI: 1962979351
Provider Name (Legal Business Name): DAVID GELIN MSN, RN, ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134-20 87TH AVE 7F
RICHMOND HILL NY
11418
US

IV. Provider business mailing address

13420 87TH AVE APT 7F
RICHMOND HILL NY
11418-1909
US

V. Phone/Fax

Practice location:
  • Phone: 917-459-0813
  • Fax:
Mailing address:
  • Phone: 917-459-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number307513
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: