Gracielle Ann Abano
Individual provider Active NPI Physical Therapist · Bronx, NY
NPI 1801429154 · NPPES record last updated Feb 14, 2020
Key facts
- NPI
- 1801429154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 032567 (NY)
- Practice address
- 6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032 - Phone
- (718) 701-4807
- NPI assigned
- Feb 14, 2020
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 032567 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 032567 | NY | Yes |
Addresses
Primary practice location
6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032
Mailing address
3050 Fairfield Ave Apt 7L
Bronx, NY 10463-3349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032567 | Other | NY | PT LICENSE |
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.