Healthcare Provider Details

I. General information

NPI: 1871324624
Provider Name (Legal Business Name): MISTRAL GALE HAY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 2ND AVE RM 701
NEW YORK NY
10017-4500
US

IV. Provider business mailing address

815 2ND AVE RM 701
NEW YORK NY
10017-4500
US

V. Phone/Fax

Practice location:
  • Phone: 212-499-0848
  • Fax:
Mailing address:
  • Phone: 212-499-0876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number052778
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: