Provider Demographics
NPI:1982905113
Name:AYESTAS, GAIL RANSOM (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:RANSOM
Last Name:AYESTAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:RANSOM-AYESTAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:9011 35TH AVE
Mailing Address - Street 2:APT. #A
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5804
Mailing Address - Country:US
Mailing Address - Phone:347-581-0741
Mailing Address - Fax:718-350-3278
Practice Address - Street 1:9011 35TH AVE
Practice Address - Street 2:APT. #A
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5804
Practice Address - Country:US
Practice Address - Phone:347-581-0741
Practice Address - Fax:718-350-3278
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000961-1251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)