Provider Demographics
NPI:1851275184
Name:NORVIL, GARLAINE
Entity type:Individual
Prefix:
First Name:GARLAINE
Middle Name:
Last Name:NORVIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S FRANKLIN AVE
Mailing Address - Street 2:P.O. BOX 1635
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6108
Mailing Address - Country:US
Mailing Address - Phone:347-570-9998
Mailing Address - Fax:
Practice Address - Street 1:144 ALBERMARLE AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2719
Practice Address - Country:US
Practice Address - Phone:347-570-9998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily