Provider Demographics
NPI:1023206687
Name:F GABRIEL LIMITED LIABILITY CO
Entity Type:Organization
Organization Name:F GABRIEL LIMITED LIABILITY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MERIAME
Authorized Official - Middle Name:
Authorized Official - Last Name:ANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-770-0202
Mailing Address - Street 1:PO BOX 6566
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-6566
Mailing Address - Country:US
Mailing Address - Phone:732-651-7122
Mailing Address - Fax:732-651-9797
Practice Address - Street 1:63 W PROSPECT ST
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5705
Practice Address - Country:US
Practice Address - Phone:732-651-7122
Practice Address - Fax:732-651-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07646200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH99514Medicare UPIN
NJ097901Medicare PIN