Healthcare Provider Details

I. General information

NPI: 1194332569
Provider Name (Legal Business Name): GABRIELLE LYNN MOROCCO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 E 100TH ST
CLEVELAND OH
44106-2104
US

IV. Provider business mailing address

2570 SOM CENTER RD
WILLOUGHBY HILLS OH
44094-9607
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-5725
  • Fax:
Mailing address:
  • Phone: 330-647-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: