Provider Demographics
NPI:1487864674
Name:LEVY, GAIL (RN,IBCLC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:RN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6107
Mailing Address - Country:US
Mailing Address - Phone:617-512-2332
Mailing Address - Fax:
Practice Address - Street 1:1 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6107
Practice Address - Country:US
Practice Address - Phone:617-512-2332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142027163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant