Healthcare Provider Details

I. General information

NPI: 1598984932
Provider Name (Legal Business Name): GABRIELLE R DICANIO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346A FRONT STREET
HEMPSTEAD NY
11746
US

IV. Provider business mailing address

34 OSAGE DR
HUNTINGTON STATION NY
11746-2036
US

V. Phone/Fax

Practice location:
  • Phone: 516-292-7111
  • Fax:
Mailing address:
  • Phone: 516-319-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number68-016934
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number68-016934
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number68-016934
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: