Kara Joan Gibbons
Individual provider Active NPI Specialist · East Norwich, NY
NPI 1609445782 · NPPES record last updated Jun 22, 2021
Key facts
- NPI
- 1609445782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 170 Radcliff Dr
East Norwich, NY 11732-1225 - Phone
- (516) 578-4762
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NY | Yes |
Addresses
Primary practice location
170 Radcliff Dr
East Norwich, NY 11732-1225
Mailing address
170 Radcliff Dr
East Norwich, NY 11732-1225
Phone (516) 578-4762
Other providers in East Norwich, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.