Provider Demographics
NPI:1659027464
Name:GYORY, LILA PEARL
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:PEARL
Last Name:GYORY
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 1:597 GRAND AVE APT 3I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-3668
Mailing Address - Country:US
Mailing Address - Phone:973-901-5596
Mailing Address - Fax:
Practice Address - Street 1:6317B METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1606
Practice Address - Country:US
Practice Address - Phone:718-456-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health