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General NPI Number Information
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NPI Number | 1821839119
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Entity Type | Individual
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Provider Name | GABRIELLE IPPOLITO RN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 184 BARTON ST
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City | BUFFALO
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State | NY
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Zip | 14213-1573
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Country | US
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Telephone | 716-881-6191
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Fax |
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Provider Business Mailing Address
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Address Line | 5255 S FREEMAN RD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-3311
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Country | US
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Telephone | 716-536-6513
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 414113
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License Number State | NY
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