Provider Demographics
NPI:1821359829
Name:TANCER, GAYLE LORI (MSED)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:LORI
Last Name:TANCER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BENTLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2619
Mailing Address - Country:US
Mailing Address - Phone:516-513-0306
Mailing Address - Fax:
Practice Address - Street 1:17 BENTLEY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2619
Practice Address - Country:US
Practice Address - Phone:516-513-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist