MEDICARE: DR. CHRISTOPHER MICHAEL GABRIELS D.C.

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
1	111N00000X	Chiropractor	X010022	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10022-4B	OTHER	NY	WORKERS COMP
2	5898064	OTHER	NY	GHI
3	10057467	OTHER	NY	CDPHP

General Provider Information

NPI Number	:	1710946579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MICHAEL GABRIELS D.C.

Provider Business Mailing Address
First Line	:	15 QUARRY ST
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-2813
Country	:	US
Telephone Number	:	845-338-0170
Fax Number	:	845-564-0094

Provider Business Practice Location Address
First Line	:	3 SPRING SQUARE BUSINESS PARK
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-7006
Country	:	US
Telephone Number	:	845-564-0083
Fax Number	:	845-564-0094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	10/16/2014

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