Provider Demographics
NPI:1548248594
Name:GABRIEL, CYNTHIA I (PT, MS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:I
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 STATE ROUTE 29
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-4518
Mailing Address - Country:US
Mailing Address - Phone:518-695-4072
Mailing Address - Fax:518-695-4866
Practice Address - Street 1:336 STATE ROUTE 29
Practice Address - Street 2:SUITE 1
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-4518
Practice Address - Country:US
Practice Address - Phone:518-695-4072
Practice Address - Fax:518-695-4866
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56309BMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER