Healthcare Provider Details

I. General information

NPI: 1386389328
Provider Name (Legal Business Name): GABRIELLA B PIETROPAOLO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 MONROE AVE STE 200R
ROCHESTER NY
14618-4600
US

IV. Provider business mailing address

713 HARRISON ST
SYRACUSE NY
13210-2305
US

V. Phone/Fax

Practice location:
  • Phone: 585-902-2290
  • Fax:
Mailing address:
  • Phone: 315-464-3148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number026193
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: