Provider Demographics
NPI:1366531626
Name:NYE, GAYLE ROBERT
Entity type:Individual
Prefix:MR
First Name:GAYLE
Middle Name:ROBERT
Last Name:NYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 GREAT PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1217
Mailing Address - Country:US
Mailing Address - Phone:781-449-1345
Mailing Address - Fax:
Practice Address - Street 1:90 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4046
Practice Address - Country:US
Practice Address - Phone:617-484-8700
Practice Address - Fax:617-484-3043
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA761231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA478141OtherTUFTS HEALTHCARE
MAAD0199OtherBCBS
MA5100275Medicaid
MAAA143246OtherHARVARD PILGRIM HEALTHCARE
MAAD0199OtherBCBS