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General NPI Number Information
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NPI Number | 1598842098
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Entity Type | Individual
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Provider Name | SEKULEO GATHERS MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 350 5TH AVE 59TH FLOOR NEW YORK PHYSICIAN PLLC
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City | NEW YORK
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State | NY
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Zip | 10118
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Country | US
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Telephone | 888-970-3777
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Fax | 888-970-3777
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Provider Business Mailing Address
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Address Line | 350 5TH AVE 59TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10118-0110
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Country | US
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Telephone | 888-970-3777
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Fax | 888-970-3777
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA09595200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 235711
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 235711
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA09595200
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License Number State | NJ
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