Provider Demographics
NPI:1932469434
Name:SANTOS, GAIL (RN)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1103
Mailing Address - Country:US
Mailing Address - Phone:631-336-0795
Mailing Address - Fax:
Practice Address - Street 1:141A OAKDALE BOHEMIA RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769
Practice Address - Country:US
Practice Address - Phone:631-316-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2023-08-14
Deactivation Date:2020-06-18
Deactivation Code:
Reactivation Date:2023-07-12
Provider Licenses
StateLicense IDTaxonomies
NY892115163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse