Gillian S Davalos, PA
Physician Assistant in Flushing, NY. Individual provider (NPI-1).
NPI number1669943973
StatusActive
Last updated in NPPESApr 15, 2020
Details
- NPI
- 1669943973
- Entity type
- Individual (NPI-1)
- Name
- Gillian S Davalos
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 12, 2018
- Certification date
- Apr 15, 2020
- Last updated
- Apr 15, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 023052-1 | NY | Yes |
Practice location
5645 Main StFlushing, NY 11355-5045
Phone 347-684-0011
Mailing address
23807 88th AveBellerose, NY 11426-1213
Phone 347-859-9180
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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