Pamela Gates
Individual provider Active NPI Specialist · Glen Head, NY
NPI 1831451806 · NPPES record last updated Jun 14, 2012
Key facts
- NPI
- 1831451806
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1541553 (NY)
- Practice address
- 12 Benjamin St
Glen Head, NY 11545-1828 - Phone
- (516) 747-9030
- NPI assigned
- Jun 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1541553 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1541553 | NY | Yes |
Addresses
Primary practice location
12 Benjamin St
Glen Head, NY 11545-1828
Mailing address
12 Benjamin St
Glen Head, NY 11545-1828
Other providers in Glen Head, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.