Individual
OPAL GAYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 ASHTON ST, BRIDGEPORT, CT 06606-2615
(718) 828-2666
Mailing address
102 ASHTON ST, BRIDGEPORT, CT 06606-2615
(718) 828-2666
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314339
NY
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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