Most Relevant Information
Provider Data
| NPI Number: | 1003225731 |
| Provider Name: | MELISA GAYLE |
| Entity Type: | Individual |
| Taxonomy Code: | 311ZA0620X |
| Specialty: | Custodial Care Facility |
| License Number: | 343144280711E |
Most Important Dates
| Enumeration Date: | 08/06/2014 |
| Last Updated: | 08/06/2014 |
Provider Practice Location
11315 204TH ST
SAINT ALBANS
NY
114122534
Practice Location Phone/Fax
| Phone: | 6468417481 |
| Fax: |
Provider Mailing Location
11315 204TH ST
SAINT ALBANS
NY
114122534
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |