MEDICARE: MRS. GAYLE J CHESTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		NY

General Provider Information

NPI Number	:	1013046358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAYLE J CHESTER

Provider Business Mailing Address
First Line	:	41 RIVERSIDE DR
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-6127
Country	:	US
Telephone Number	:	845-659-1535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 WESTCHESTER AVE
Second Line	:	SUITE N230
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3516
Country	:	US
Telephone Number	:	914-576-5292
Fax Number	:	914-576-3983

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2007
Last Update Date	:	03/16/2015

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