Provider Demographics
NPI:1023384302
Name:GAWLE, ANNA A (RN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:A
Last Name:GAWLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:A
Other - Last Name:GAWLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:535 83RD ST
Mailing Address - Street 2:APT. 3F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4529
Mailing Address - Country:US
Mailing Address - Phone:718-234-1957
Mailing Address - Fax:
Practice Address - Street 1:415 OVINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1539
Practice Address - Country:US
Practice Address - Phone:718-491-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY549202-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool