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Gilbert B Vicencio

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

254 Easton Ave, New Brunswick, NJ 08901-1766

PECOS Enrollment

This provider is enrolled in PECOS as GILBERT VICENCIO.

Based on the most recent information from CMS, provider Gilbert B Vicencio is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1063042604
Provider Type
Individual
Full Name
Vicencio, Gilbert B
Title
Mr.
Credential
MSN, FNP-BC

Gender
Male
Sole Proprietor
No
Enumeration Date
1/23/2020
Last Updated
1/23/2020

Contact Information

Practice Location

254 Easton Ave, New Brunswick, NJ 08901-1766

(732) 745-6671

Unlisted Fax

Mailing Location

26 Evergreen Rd, Somerset, NJ 08873-2822

(732) 690-9479

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 26NJ00997100 New Jersey

Gilbert B Vicencio

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hernandez, Melissa

Ku, Anna W

Valdez, Adrienne Gail

Patel, Khooshbu

Catalano, Carolyn

Gelinas, Chih-Li

Gabel, Alissa

Gurdak, Joanna M

Quezada Mejia, Luz Charielle

Pechera, Jasper