MEDICARE: NATALIE GAYLE PSYCHIATRIC NP PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F403749-01	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1275232522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIE GAYLE PSYCHIATRIC NP PLLC

Provider Business Mailing Address
First Line	:	555 BROADHOLLOW RD STE 305
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-5018
Country	:	US
Telephone Number	:	631-245-0089
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 BROADHOLLOW RD STE 305
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-5018
Country	:	US
Telephone Number	:	631-245-0089
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATALIE GAYLE
Credential	:	NP
Telephone Number	:	631-671-1146

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	10/23/2024

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