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General NPI Number Information
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NPI Number | 1629935333
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Entity Type | Individual
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Provider Name | GABRIELLE LASALA PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 718-670-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CORWIN AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3911
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Country | US
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Telephone | 516-776-2667
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NY
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