Provider Demographics
NPI:1508005893
Name:HARRIS, GAYLE JEANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:JEANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3003
Mailing Address - Country:US
Mailing Address - Phone:914-967-5565
Mailing Address - Fax:914-967-5814
Practice Address - Street 1:14 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3003
Practice Address - Country:US
Practice Address - Phone:914-967-5565
Practice Address - Fax:914-967-5814
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT5933-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist