Provider Demographics
NPI:1710961628
Name:MILTON, GAYLE P (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:P
Last Name:MILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 BEACH 129TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1516
Mailing Address - Country:US
Mailing Address - Phone:718-945-2600
Mailing Address - Fax:718-945-3987
Practice Address - Street 1:431 BEACH 129TH ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1516
Practice Address - Country:US
Practice Address - Phone:718-945-2600
Practice Address - Fax:718-945-3987
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178578208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01394545Medicaid
NY01394545Medicaid
NY48F721Medicare ID - Type Unspecified