Healthcare Provider Details

I. General information

NPI: 1437882453
Provider Name (Legal Business Name): GABRIELLA SCIBETTA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # 325
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

99 ELMBANK ST APT SUITE
STATEN ISLAND NY
10312-6022
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-7576
  • Fax:
Mailing address:
  • Phone: 347-933-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: