Basic Information
| Provider Information | |||||||||
| NPI: | 1356784383 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | UKATU | ||||||||
| FirstName: | GAIL | ||||||||
| MiddleName: | NKOLIKA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 RXR PLZ FL 13 | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115561301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164530435 | ||||||||
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| Practice Location | |||||||||
| Address1: | 80 W 125TH ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100274502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129130820 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 01/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 296332 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | 208600000X | 125.062787 | IL | N | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.