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General NPI Number Information
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NPI Number | 1093022337
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Entity Type | Individual
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Provider Name | DEBORAH A GIFTOS MSED
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 127 N CROSS RD
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City | CHATHAM
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State | NY
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Zip | 12037-1176
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Country | US
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Telephone | 518-858-7794
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Fax | 518-392-4943
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Provider Business Mailing Address
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Address Line | 127 N CROSS RD
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City | CHATHAM
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State | NY
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Zip | 12037-1176
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Country | US
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Telephone | 518-858-7794
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Fax | 518-392-4943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 409240032
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License Number State | NY
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