Provider Demographics
NPI:1104201490
Name:GAIL NOPPE BRANDON, LLC
Entity Type:Organization
Organization Name:GAIL NOPPE BRANDON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOPPE-BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-741-9868
Mailing Address - Street 1:7 E 14TH ST
Mailing Address - Street 2:1207
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3115
Mailing Address - Country:US
Mailing Address - Phone:212-741-9868
Mailing Address - Fax:
Practice Address - Street 1:7 E 14TH ST
Practice Address - Street 2:1207
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3115
Practice Address - Country:US
Practice Address - Phone:212-741-9868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08340411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty