Provider Demographics
NPI:1629899810
Name:HALL, GABRIELLA ROSE (COTA)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:ROSE
Last Name:HALL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 RIDGEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4211
Mailing Address - Country:US
Mailing Address - Phone:618-792-9316
Mailing Address - Fax:
Practice Address - Street 1:696 DUTCHESS TPKE STE C
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6445
Practice Address - Country:US
Practice Address - Phone:845-202-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011610-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist