Provider Demographics
NPI:1265223440
Name:MCLEAN, GAIL VIRGINIA
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:VIRGINIA
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 PAUL AVE APT 20D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-1016
Mailing Address - Country:US
Mailing Address - Phone:646-295-0589
Mailing Address - Fax:
Practice Address - Street 1:73 MARKET ST STE 376
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7619
Practice Address - Country:US
Practice Address - Phone:877-327-6855
Practice Address - Fax:914-327-2844
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program