Provider Demographics
NPI:1861619074
Name:GAHLES, NANCY M (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:GAHLES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BEACH 137TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1331
Mailing Address - Country:US
Mailing Address - Phone:718-634-4577
Mailing Address - Fax:718-634-4577
Practice Address - Street 1:241 BEACH 137TH ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1331
Practice Address - Country:US
Practice Address - Phone:718-634-4577
Practice Address - Fax:718-634-4577
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002406-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13-3421548OtherEIN
NY13-3421548OtherEIN