Healthcare Provider Details

I. General information

NPI: 1639088438
Provider Name (Legal Business Name): MADLINE W GABRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

465 KEARNY AVE
KEARNY NJ
07032-2702
US

IV. Provider business mailing address

310 IVY ST
KEARNY NJ
07032-3502
US

V. Phone/Fax

Practice location:
  • Phone: 201-428-2376
  • Fax:
Mailing address:
  • Phone: 201-844-7323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04508100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: