Individual
GALE MARIE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W 57TH ST, NEW YORK, NY 10019-2902
(212) 293-3000
(212) 293-2030
Mailing address
500 W 57TH ST, NEW YORK, NY 10019-2902
(212) 293-3000
(212) 293-2030
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
404353
NY
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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