Gabriella Haycock
Individual provider Active NPI Physical Therapist · Alexandria Bay, NY
NPI 1801437272 · NPPES record last updated Oct 7, 2019
Key facts
- NPI
- 1801437272
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 045010 (NY)
- Practice address
- 4 Fuller St
Alexandria Bay, NY 13607-1391 - Phone
- (315) 482-2511
- NPI assigned
- Oct 7, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 045010 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 045010 | NY | Yes |
Addresses
Primary practice location
4 Fuller St
Alexandria Bay, NY 13607-1391
Mailing address
PO Box 212
Depauville, NY 13632-0212
Other providers in Alexandria Bay, NY
- Nickolas Frears
- Bradley Duane Frey
- Nancy A Girard
- Shelby Gonsalves
- Abbie Dolores Hannigan
- Michael Hohs
- Jeralee Jobson
- Kimberly Ann Kernehan
- Robert J Kline
- Jade Kool
All providers in Alexandria Bay, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2019. 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.