Individual
DAVID WAYNE GATELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
79 MIDDLEVILLE RD, VA MEDICAL CENTER, PSYCHOLOGY SERVICE (116B), NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, VA MEDICAL CENTER, PSYCHOLOGY SERVICE (116B), NORTHPORT, NY 11768-2200
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
011314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01478091
—
NY
Enumeration date
08/02/2005
Last updated
07/11/2007
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