DR. KELLIE NICOLE GERGOUDIS MD MSCR NPI 1730742099

NPI Information

DR. Kellie Nicole Gergoudis, MD, MSCR is a student in an organized health care education training program in New York, NY. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Kellie Nicole Gergoudis, MD, MSCR NPI is 1730742099. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 GUSTAVE L LEVY PL
NEW YORK, NY
ZIP 10029-504
Phone: (212) 659-8734

The enumeration date for this NPI number is 4/22/2019 and was last updated on 5/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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