MEDICARE: GABRIELA MARGARITA BLANCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1700778826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA MARGARITA BLANCO

Provider Business Mailing Address
First Line	:	491 S FIR AVE
Second Line	:
City	:	GALLOWAY
State	:	NJ
Zip	:	08205-4419
Country	:	US
Telephone Number	:	845-820-7408
Fax Number	:

Provider Business Practice Location Address
First Line	:	897 12TH ST UNIT 101
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-1363
Country	:	US
Telephone Number	:	609-878-0892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	07/15/2025

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Directions to “ GABRIELA MARGARITA BLANCO ” Practice Location

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