Provider Demographics
NPI:1568803021
Name:OBERLANDER, GAIL
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:OBERLANDER
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 1:387 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3969
Mailing Address - Country:US
Mailing Address - Phone:917-991-6472
Mailing Address - Fax:
Practice Address - Street 1:387 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3969
Practice Address - Country:US
Practice Address - Phone:917-991-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTEACHER DEAF101YS0200X, 235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool