Healthcare Provider Details

I. General information

NPI: 1609704121
Provider Name (Legal Business Name): GABRIELLA CARMELLA FARAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SEAVIEW AVE
STATEN ISLAND NY
10305-3401
US

IV. Provider business mailing address

84 BROOKSIDE AVE
STATEN ISLAND NY
10310-2600
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-9000
  • Fax:
Mailing address:
  • Phone: 347-979-5859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129925-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: