Provider Demographics
NPI:1518501816
Name:GAYLE - MUHAMMAD, MARVALYN
Entity Type:Individual
Prefix:
First Name:MARVALYN
Middle Name:
Last Name:GAYLE - MUHAMMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2175
Mailing Address - Country:US
Mailing Address - Phone:646-323-6449
Mailing Address - Fax:
Practice Address - Street 1:86 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2175
Practice Address - Country:US
Practice Address - Phone:646-323-6449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty