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General NPI Number Information
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NPI Number | 1215745070
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Entity Type | Individual
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Provider Name | LYRONIE MELISSIA GAYLE LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 10 CARMELLO RD
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City | NEWBURGH
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State | NY
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Zip | 12550-1319
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Country | US
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Telephone | 845-500-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 55 OCEAN AVE APT C5
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City | BROOKLYN
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State | NY
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Zip | 11225-3617
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Country | US
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Telephone | 929-331-5806
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 118641-01
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License Number State | NY
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