Healthcare Provider Details

I. General information

NPI: 1205155249
Provider Name (Legal Business Name): ASHLEY GABRIEL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 SAND PIT RD SUITE 203
DANBURY CT
06810-4042
US

IV. Provider business mailing address

226 WHITE ST SUITE 203
DANBURY CT
06810-6814
US

V. Phone/Fax

Practice location:
  • Phone: 203-798-9702
  • Fax:
Mailing address:
  • Phone: 203-798-9702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18317
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009243
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3548
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: