Provider Demographics
NPI:1700183712
Name:ROSSELOT, GAIL ALISON (NP)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ALISON
Last Name:ROSSELOT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 TODD LN
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1710
Mailing Address - Country:US
Mailing Address - Phone:914-923-7073
Mailing Address - Fax:914-923-7076
Practice Address - Street 1:140 TODD LN
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1710
Practice Address - Country:US
Practice Address - Phone:914-923-7073
Practice Address - Fax:914-923-7076
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301011363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health