Provider Demographics
NPI:1336399922
Name:CARBONE WILLIAMS, GAIL M
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:M
Last Name:CARBONE WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:M
Other - Last Name:CARBONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:32 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2108
Mailing Address - Country:US
Mailing Address - Phone:631-654-3308
Mailing Address - Fax:
Practice Address - Street 1:32 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-2108
Practice Address - Country:US
Practice Address - Phone:631-654-3308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010813-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist