Healthcare Provider Details

I. General information

NPI: 1023490075
Provider Name (Legal Business Name): GABRIELLA SOPHIA SEHNE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GABRIELLA SEHNE FNP

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 NIMITZ RD
SAINT JAMES NY
11780-2926
US

IV. Provider business mailing address

12 NIMITZ RD
SAINT JAMES NY
11780-2926
US

V. Phone/Fax

Practice location:
  • Phone: 631-241-3545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number346419
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number689006
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: