Provider Demographics
NPI:1841005907
Name:GAY, GAW LER
Entity type:Individual
Prefix:
First Name:GAW
Middle Name:LER
Last Name:GAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12921 HARTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1322
Mailing Address - Country:US
Mailing Address - Phone:651-440-8186
Mailing Address - Fax:
Practice Address - Street 1:12921 HARTMAN AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1322
Practice Address - Country:US
Practice Address - Phone:651-440-8186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide