=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952768574
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE INSTITUTE FOR FAMILY HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2016
-----------------------------------------------------
Last Update Date | 04/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 176 E 115TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10029-2031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-860-5812
-----------------------------------------------------
Fax | 212-860-6072
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 279 MAIN ST SUITE 101
-----------------------------------------------------
City | NEW PALTZ
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12561-1623
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-255-3766
-----------------------------------------------------
Fax | 845-255-3753
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | ERIC GAYLE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 212-633-0800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------