Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X0076691 | NY |
NPI | 1003999632 |
---|---|
Provider Name | Dr. Gail Stevens |
First Address | Mineola, NY 11501-2098 |
Second Address | Mineola, NY 11501-2097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 06/03/2017 |