Healthcare Provider Details

I. General information

NPI: 1639287055
Provider Name (Legal Business Name): GAIL A BESSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3414 CHURCH AVE
BROOKLYN NY
11203-2714
US

IV. Provider business mailing address

150 55TH ST STATION 20
BROOKLYN NY
11220-2508
US

V. Phone/Fax

Practice location:
  • Phone: 718-940-4949
  • Fax: 718-940-2914
Mailing address:
  • Phone: 718-630-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number211088
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: