Provider Demographics
NPI:1295937035
Name:GAY, DIANE B (NP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:B
Last Name:GAY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:260 PATCHOGUE YAPHANK RD
Mailing Address - Street 2:
Mailing Address - City:E PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4886
Mailing Address - Country:US
Mailing Address - Phone:631-289-0300
Mailing Address - Fax:631-289-0402
Practice Address - Street 1:260 PATCHOGUE YAPHANK RD
Practice Address - Street 2:
Practice Address - City:E PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4886
Practice Address - Country:US
Practice Address - Phone:631-289-0300
Practice Address - Fax:631-289-0402
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2010-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY271847-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner