Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 241288 | NY |
N | 207PP0204X | Pediatric Emergency Physician | 25MA08093900 | NJ |
Y | 208000000X | Pediatrician | 25MA08093900 | NJ |
NPI | 1265524110 |
---|---|
Provider Name | Dr. John Gabriel |
First Address | Old Bridge, NJ 08857-3570 |
Second Address | East Brunswick, NJ 08816-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 12/01/2011 |