Provider Demographics
NPI:1497010698
Name:GAYLE, TRUDY-ANN KIMBERLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRUDY-ANN
Middle Name:KIMBERLEY
Last Name:GAYLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14335 182ND PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3222
Mailing Address - Country:US
Mailing Address - Phone:917-858-8448
Mailing Address - Fax:718-613-6438
Practice Address - Street 1:14335 182ND PL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3222
Practice Address - Country:US
Practice Address - Phone:917-858-8448
Practice Address - Fax:718-613-6438
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021529103TC0700X
NYP84622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical