Gilligan, Colleen Grace

Gilligan, Colleen Grace is an sole proprietor health care provider with primary practice located at 2171 Jericho Tpke Ste Ll3 , Commack NY 11725-2900. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Gilligan, Colleen Grace can be contacted via phone (631) 603-5002.

Contact Information

Primary practice address
2171 Jericho Tpke Ste Ll3 Commack NY 11725-2900
Phone: (631) 603-5002
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1821370800
LBN Legal business name Gilligan, Colleen Grace
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2011
Last updated Mar 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821370800 NPPES
New York Other 823156527 PSCHOTHERAPY/DIRECT CARE

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