Provider Demographics
NPI:1962979351
Name:GELIN, DAVID (MSN, RN, ANP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GELIN
Suffix:
Gender:M
Credentials:MSN, RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13420 87TH AVE APT 7F
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1909
Mailing Address - Country:US
Mailing Address - Phone:917-459-0813
Mailing Address - Fax:
Practice Address - Street 1:134-20 87TH AVE
Practice Address - Street 2:7F
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418
Practice Address - Country:US
Practice Address - Phone:917-459-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307513363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health