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General NPI Number Information
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NPI Number | 1508586801
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Entity Type | Individual
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Provider Name | GABRIEL STUMP
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Gender | Male
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 377 PARK AVE S FL 2
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City | NEW YORK
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State | NY
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Zip | 10016-8807
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Country | US
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Telephone | 862-337-0631
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Fax |
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Provider Business Mailing Address
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Address Line | 454 SAINT NICHOLAS AVE APT 2N
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City | NEW YORK
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State | NY
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Zip | 10027-7664
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Country | US
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Telephone | 303-249-0802
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 049152-01
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License Number State | NY
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