Provider Demographics
NPI:1467519942
Name:GAYLE, MARISSA Y (RTT)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:Y
Last Name:GAYLE
Suffix:
Gender:F
Credentials:RTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 NEW HEMPSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2430
Mailing Address - Country:US
Mailing Address - Phone:914-646-4795
Mailing Address - Fax:
Practice Address - Street 1:177 NEW HEMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2430
Practice Address - Country:US
Practice Address - Phone:914-646-4795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6417232471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy