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NPI Code Detail

MEDICARE: MRS. GAYLE BUCKLEY MD

MEDICARE:  MRS. GAYLE  BUCKLEY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician107075NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972587681
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GAYLE BUCKLEY MD
Provider Business Mailing Address
First Line : 318 RUHLE RD S
Second Line :
City : BALLSTON LAKE
State : NY
Zip : 12019-1030
Country : US
Telephone Number : 518-899-4133
Fax Number : 518-899-5764
Provider Business Practice Location Address
First Line : 318 RUHLE RD S
Second Line :
City : BALLSTON LAKE
State : NY
Zip : 12019-1030
Country : US
Telephone Number : 518-899-4133
Fax Number : 518-899-5764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. GAYLE BUCKLEY MD” Practice Location

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