Basic Information
| Provider Information | |||||||||
| NPI: | 1033116728 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAY | ||||||||
| FirstName: | TULIE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 85 HAMLET RD | ||||||||
| Address2: | |||||||||
| City: | LEVITTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117564103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167356784 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 MADISON ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112161509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186367500 | ||||||||
| FaxNumber: | 7186360513 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F332702-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 02099061 | 05 | NY | MEDICAID | MG0519009 | 01 | NY | DEA | OTHER |