Provider Demographics
NPI:1114074721
Name:GALE, STANLEY WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:WILLIAM
Last Name:GALE
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 1:6 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4109
Mailing Address - Country:US
Mailing Address - Phone:401-831-7756
Mailing Address - Fax:
Practice Address - Street 1:6 IRVING AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4109
Practice Address - Country:US
Practice Address - Phone:401-831-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD053532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI000846OtherBLUE CHIP
RI15-10420OtherUNITED HEALTHCARE
RI561-2OtherHEALTHMATE
RIC90688Medicare UPIN