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General NPI Number Information
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NPI Number | 1780400648
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Entity Type | Individual
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Provider Name | GABRIELA BOUZAGLOU DPT
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 55 BROADWAY STE 201
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City | NEW YORK
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State | NY
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Zip | 10006-3759
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Country | US
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Telephone | 646-870-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 WASHINGTON ST APT 4
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City | HOBOKEN
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State | NJ
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Zip | 07030-5456
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Country | US
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Telephone | 818-723-7998
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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 | 053488
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License Number State | NY
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