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General NPI Number Information
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NPI Number | 1154423424
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Entity Type | Individual
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Provider Name | SANDRA L GAVIOLA RRT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VA MEDICAL CENTER 1700 S. LINCOLN AVENUE
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City | LEBANON
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State | PA
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Zip | 17042
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Country | US
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Telephone | 717-272-6621
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Fax | 717-228-5950
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Provider Business Mailing Address
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Address Line | 27 ANVIL MILL QUARTERS S. LANCASTER STREET
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City | ANNVILLE
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State | PA
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Zip | 17003-1854
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Country | US
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Telephone | 412-527-9321
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Fax | 717-228-5950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | YO000566L
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License Number State | PA
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