Provider Demographics
NPI:1982049128
Name:GAYLE, ROY ANTHONY
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:ANTHONY
Last Name:GAYLE
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 1:164 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3002
Mailing Address - Country:US
Mailing Address - Phone:857-222-9904
Mailing Address - Fax:401-722-1598
Practice Address - Street 1:164 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3002
Practice Address - Country:US
Practice Address - Phone:857-222-9904
Practice Address - Fax:401-722-1598
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2214168343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)