Provider Demographics
NPI:1447465125
Name:GOREN, GAYLE SUZANNE (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:SUZANNE
Last Name:GOREN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:276 W 119TH ST
Mailing Address - Street 2:APT. 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-1113
Mailing Address - Country:US
Mailing Address - Phone:917-673-6269
Mailing Address - Fax:212-305-9732
Practice Address - Street 1:635 W 165TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3724
Practice Address - Country:US
Practice Address - Phone:212-305-9835
Practice Address - Fax:212-305-9732
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY2251612084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine