MEDICARE: MS. SANDRA ESTHER GAYLE RN

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	163W00000X	Registered Nurse	498990	NY

General Provider Information

NPI Number	:	1053686212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA ESTHER GAYLE RN

Provider Business Mailing Address
First Line	:	610 HENRY ST
Second Line	:	PS 146/SS448
City	:	BROOKLYN
State	:	NY
Zip	:	11231-2612
Country	:	US
Telephone Number	:	718-923-4750
Fax Number	:	718-923-4780

Provider Business Practice Location Address
First Line	:	610 HENRY ST
Second Line	:	PS 146/SS448
City	:	BROOKLYN
State	:	NY
Zip	:	11231-2612
Country	:	US
Telephone Number	:	718-923-4750
Fax Number	:	718-923-4780

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

Provider Enumeration Date	:	03/20/2012
Last Update Date	:	03/20/2012

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