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General NPI Number Information
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NPI Number | 1922500354
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Entity Type | Individual
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Provider Name | GABRIELLE HERARD FNP
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 160 MIDDLE RD
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City | SAYVILLE
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State | NY
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Zip | 11782-3126
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Country | US
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Telephone | 917-687-4762
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Fax |
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Provider Business Mailing Address
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Address Line | 3 POE PL
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-2200
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 342172
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License Number State | NY
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