MEDICARE: MRS. GAIL CAMPBELL MS, PT

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	2251P0200X	Pediatric Physical Therapist	021553-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811034903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAIL CAMPBELL MS, PT

Provider Business Mailing Address
First Line	:	10 WEDGEWOOD DR
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-2825
Country	:	US
Telephone Number	:	516-398-4339
Fax Number	:	516-706-1833

Provider Business Practice Location Address
First Line	:	10 WEDGEWOOD DR
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-2825
Country	:	US
Telephone Number	:	516-398-4339
Fax Number	:	516-706-1833

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/28/2012

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