Healthcare Provider Details

I. General information

NPI: 1023858495
Provider Name (Legal Business Name): EMMA LOUISE GAMBELUNGHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4195 US 64 W STE 9&10
MURPHY NC
28906-8108
US

IV. Provider business mailing address

4195 US 64 W STE 9&10
MURPHY NC
28906-8108
US

V. Phone/Fax

Practice location:
  • Phone: 347-687-8873
  • Fax: 833-664-8707
Mailing address:
  • Phone: 347-687-8873
  • Fax: 833-664-8707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: