Provider Demographics
NPI:1104185545
Name:GAEL, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GAEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 RIVER RD
Mailing Address - Street 2:APT. 4D
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1459
Mailing Address - Country:US
Mailing Address - Phone:201-886-2495
Mailing Address - Fax:
Practice Address - Street 1:972 ROUTE 45
Practice Address - Street 2:SUITE103
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3519
Practice Address - Country:US
Practice Address - Phone:212-472-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine