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NPI Code Detail

MEDICARE: EMILY GILLIGAN EPPEL PA-C

MEDICARE:   EMILY GILLIGAN EPPEL  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant022272-1NY

General Provider Information

NPI Number : 1245711753
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY GILLIGAN EPPEL PA-C
Provider Business Mailing Address
First Line : 310 GREENWICH ST APT 10E
Second Line :
City : NEW YORK
State : NY
Zip : 10013-2710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2701 QUEENS PLZ N FL 10
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4022
Country : US
Telephone Number : 866-295-4527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2018
Last Update Date : 03/07/2019

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