Healthcare Provider Details

I. General information

NPI: 1710961628
Provider Name (Legal Business Name): GAYLE P MILTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 BEACH 129TH ST
BELLE HARBOR NY
11694-1516
US

IV. Provider business mailing address

431 BEACH 129TH ST
BELLE HARBOR NY
11694-1516
US

V. Phone/Fax

Practice location:
  • Phone: 718-945-2600
  • Fax: 718-945-3987
Mailing address:
  • Phone: 718-945-2600
  • Fax: 718-945-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number178578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: