Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC010310 | PA |
NPI | 1033343322 |
---|---|
Provider Name | Suzanne Gabriele |
First Address | Lakewood, NJ 08701-6927 |
Second Address | Lakewood, NJ 08701-6927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 14/05/2009 |