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NPI Code Detail

MEDICARE: MRS. GABRIELLE ROSE BRYSON

MEDICARE: MRS. GABRIELLE ROSE BRYSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1326439753
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GABRIELLE ROSE BRYSON
Provider Business Mailing Address
First Line : 3713 HUNT RD
Second Line :
City : WANTAGH
State : NY
Zip : 11793-1541
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6125 MARATHON PKWY
Second Line :
City : LITTLE NECK
State : NY
Zip : 11362-2042
Country : US
Telephone Number : 718-224-8060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2015
Last Update Date : 06/21/2024

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Directions to “ MRS. GABRIELLE ROSE BRYSON ” Practice Location

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