| Doctor Name: | ELIZABETH RUTH GENTILE |
| NPI Number: | 1538200753 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 101630 |
| Business Practice Address: | 35 Ruritan Park Rd Stony Point, NC - 286788928 |
| Business Phone Number: | 7045859373 |
| Business Fax Number: | 7045859397 |
| Mailing Address: | 935 Shotwell Rd Suite 108, CLAYTON |
| State: | NC |
| Postal Code: | 27520 |
| Phone Number: | 7045859373 |
| Fax Number: | 7045859397 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 101630 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |