Provider Demographics
NPI:1598849424
Name:ATLAS, GAYLE (DO)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:
Last Name:ATLAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748
Mailing Address - Country:US
Mailing Address - Phone:732-264-1127
Mailing Address - Fax:732-264-0670
Practice Address - Street 1:110 E 59TH ST
Practice Address - Street 2:SUITE 10B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:732-264-1127
Practice Address - Fax:732-264-0670
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1918701207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26I9Y1Medicare ID - Type Unspecified
F73371Medicare UPIN