Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001967 | NY |
NPI | 1073164562 |
---|---|
Provider Name | Danna Gilboy |
First Address | Elmira, NY 14905-1634 |
Second Address | Elmira, NY 14905-1634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2019 |
Last Update Date | 25/09/2019 |