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General NPI Number Information
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NPI Number | 1225890791
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Entity Type | Organization
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Legal Business Name | GABRIEL ENTERPRISES L.L.C.
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 702 CITY CENTER BLVD STE C
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3096
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Country | US
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Telephone | 757-706-3768
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Fax |
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Provider Business Mailing Address
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Address Line | 496 TRUMBLE LN
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-1471
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Country | US
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Telephone | 757-842-3056
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Fax |
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Authorized Official
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Title or Position | CEO/OFFICE MANAGER
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Name | MR. MARVIN JAMES GABRIEL SR.
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Credential |
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Telephone | 757-842-3056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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