Provider Demographics
NPI:1770859589
Name:GAYAS, GEMUEL LABIANO (RPT)
Entity Type:Individual
Prefix:MR
First Name:GEMUEL
Middle Name:LABIANO
Last Name:GAYAS
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 JUSTICE AVE APT 7O
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4511
Mailing Address - Country:US
Mailing Address - Phone:908-265-7862
Mailing Address - Fax:
Practice Address - Street 1:8730 JUSTICE AVE APT 7O
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4511
Practice Address - Country:US
Practice Address - Phone:908-265-7862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020961-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist