Provider Demographics
NPI:1053080812
Name:BANDELLI, GABRIELE (DPT)
Entity Type:Individual
Prefix:
First Name:GABRIELE
Middle Name:
Last Name:BANDELLI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MEETING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2220
Mailing Address - Country:US
Mailing Address - Phone:732-784-6545
Mailing Address - Fax:732-240-5280
Practice Address - Street 1:209 APPLEGARTH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3842
Practice Address - Country:US
Practice Address - Phone:732-992-8200
Practice Address - Fax:609-642-6794
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02040700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist