Provider Demographics
NPI:1285913921
Name:ESCOBAR, GISELE ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:GISELE
Middle Name:ELIZABETH
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:16S ROOM 087
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7191
Mailing Address - Country:US
Mailing Address - Phone:631-444-2901
Mailing Address - Fax:631-444-8842
Practice Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Practice Address - Street 2:16S ROOM 087
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7191
Practice Address - Country:US
Practice Address - Phone:631-444-2901
Practice Address - Fax:631-444-8842
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY305816363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health