Healthcare Provider Details

I. General information

NPI: 1558634659
Provider Name (Legal Business Name): THE INSTITUTE FOR FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1879 MADISON AVE
NEW YORK NY
10035-2709
US

IV. Provider business mailing address

CL # 4655 PO BOX 95000
PHILADELPHIA PA
19195-4655
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-4500
  • Fax: 212-423-4577
Mailing address:
  • Phone: 845-255-3435
  • Fax: 845-256-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC GAYLE
Title or Position: PRESIDENT AND CEO
Credential: MD
Phone: 212-633-0800