Basic Information
| Provider Information | |||||||||
| NPI: | 1902138571 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GAYLE | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | RD, LDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5445 LANARK RD STE 301 | ||||||||
| Address2: | |||||||||
| City: | CENTER VALLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180348694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845267300 | ||||||||
| FaxNumber: | 8332049606 | ||||||||
| Practice Location | |||||||||
| Address1: | 5445 LANARK RD STE 301 | ||||||||
| Address2: | |||||||||
| City: | CENTER VALLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180348694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845267300 | ||||||||
| FaxNumber: | 8332049606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2010 | ||||||||
| LastUpdateDate: | 01/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DN000562 | PA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.