Fabrice Da'Val Gantt, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

274690 Issued in NY

Practice address

261 9TH St
Brooklyn, NY 11215-3905

Phone

(718) 369-3812

NPI assigned

Jul 1, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1639749500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 WILLOUGHBY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112066412",
            "telephone_number": "718-288-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153905",
            "telephone_number": "718-369-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "FABRICE",
        "middle_name": "DA'VAL",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "274690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacky Ganthier
• Marie Ganthier
• Saraphina Ganthier
• Anna Gantman
• Yevgeniya Gantman, PT
• Esther Gantz
• Shoshana Gantz, M.S.
• Daniel Ganz, M.D.
• Danielle Ganz
• Marc Ganz, MD, MPH, MBA

• Licensed Practical Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.