MEDICARE: GABRIELLE MELISSA APPLEBAUM

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	171100000X	Acupuncturist	AK0010056	PA

General Provider Information

NPI Number	:	1982131512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE MELISSA APPLEBAUM

Provider Business Mailing Address
First Line	:	301A CATHARINE STREET
Second Line	:
City	:	PHILADLEPHIA
State	:	PA
Zip	:	19147
Country	:	US
Telephone Number	:	215-341-1455
Fax Number	:

Provider Business Practice Location Address
First Line	:	728 S 4TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3120
Country	:	US
Telephone Number	:	215-922-3235
Fax Number	:

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

Provider Enumeration Date	:	05/14/2017
Last Update Date	:	05/14/2017

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