Individual
EBONY JANELLI POWELL GAYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 SHAKESPEARE AVE, BRONX, NY 10452-3012
(718) 583-7736
(718) 537-6180
Mailing address
2626 HALPERIN AVE, BRONX, NY 10461-2631
(718) 618-0401
(347) 479-1303
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
P130068
NY
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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