Healthcare Provider Details

I. General information

NPI: 1871419176
Provider Name (Legal Business Name): GABRIELLE ERIN TANTLEFF AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 FLORAL VALE BLVD STE A
YARDLEY PA
19067-5522
US

IV. Provider business mailing address

926 HEWLETT DR
VALLEY STREAM NY
11581-2727
US

V. Phone/Fax

Practice location:
  • Phone: 267-399-4004
  • Fax:
Mailing address:
  • Phone: 516-317-1233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00141400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT007104
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: