Provider Demographics
NPI:1053083691
Name:GABRIEL, TAYLOR (PT, DPT CSCS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PT, DPT CSCS
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:888-830-4125
Mailing Address - Fax:
Practice Address - Street 1:254 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2633
Practice Address - Country:US
Practice Address - Phone:551-222-4396
Practice Address - Fax:551-222-4398
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02024000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist