Provider Demographics
NPI:1811034903
Name:CAMPBELL, GAIL (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2825
Mailing Address - Country:US
Mailing Address - Phone:516-398-4339
Mailing Address - Fax:516-706-1833
Practice Address - Street 1:10 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2825
Practice Address - Country:US
Practice Address - Phone:516-398-4339
Practice Address - Fax:516-706-1833
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021553-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02622599Medicaid