Provider Demographics
NPI:1154999522
Name:GAITE, MICHAELLA MARIE YULIENCO (DO)
Entity type:Individual
Prefix:
First Name:MICHAELLA
Middle Name:MARIE YULIENCO
Last Name:GAITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 HEMLOCK PL
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2031
Mailing Address - Country:US
Mailing Address - Phone:714-213-6272
Mailing Address - Fax:
Practice Address - Street 1:400 NORTH JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:304-645-3220
Practice Address - Fax:304-647-1273
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program