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General NPI Number Information
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NPI Number | 1194816736
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Entity Type | Individual
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Provider Name | GAYLE PARKER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 10/15/2023
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Provider Practice Location Address
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Address Line | 1991 SMITH ST STE 200
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City | MERRICK
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State | NY
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Zip | 11566-3578
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Country | US
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Telephone | 718-268-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 25 NANCY PL
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City | MASSAPEQUA
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State | NY
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Zip | 11758-4322
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Country | US
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Telephone | 917-348-4341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 010498-1
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License Number State | NY
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