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General NPI Number Information
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NPI Number | 1215626767
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Entity Type | Organization
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Legal Business Name | M GIBBS WORKFORCE KERVIN LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 21503 JAMAICA AVE # 1078
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428-1783
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Country | US
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Telephone | 516-518-4506
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Fax | 929-299-1525
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Provider Business Mailing Address
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Address Line | PO BOX 930013
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City | FAR ROCKAWAY
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State | NY
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Zip | 11693-0013
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Country | US
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Telephone | 516-518-4506
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KERVIN GIBBS
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Credential |
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Telephone | 718-825-1784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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