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General NPI Number Information
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NPI Number | 1205457975
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Entity Type | Individual
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Provider Name | GABRIEL DINATALE
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Gender | Male
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 1300 YORK AVE # F309-C
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City | NEW YORK
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State | NY
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Zip | 10065-4805
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Country | US
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Telephone | 212-746-7853
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Fax |
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Provider Business Mailing Address
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Address Line | 800 ADMIRALS WAY UNIT 1817
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City | PHILADELPHIA
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State | PA
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Zip | 19146-5240
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Country | US
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Telephone | 856-745-1193
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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