Thamara Gabriel

Individual provider Active NPI Licensed Practical Nurse · Haverstraw, NY

NPI 1043792203 · NPPES record last updated Sep 5, 2018

Key facts

NPI
1043792203
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
3253491 (NY)
Practice address
68 Village ML
Haverstraw, NY 10927-1065
Phone
(845) 598-6672
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3253491NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 3253491 NY Yes

Addresses

Primary practice location

68 Village ML
Haverstraw, NY 10927-1065

Mailing address

68 Village ML
Haverstraw, NY 10927-1065
Phone (845) 598-6672

Other providers in Haverstraw, NY

All providers in Haverstraw, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.