Provider Demographics
NPI:1033311725
Name:GABRIEL, MEL (DC)
Entity Type:Individual
Prefix:MR
First Name:MEL
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 3RD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5140
Mailing Address - Country:US
Mailing Address - Phone:203-325-1533
Mailing Address - Fax:203-327-9656
Practice Address - Street 1:19 3RD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5140
Practice Address - Country:US
Practice Address - Phone:203-325-1533
Practice Address - Fax:203-327-9656
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor