Provider Demographics
NPI:1093338790
Name:SHERMANSKI, GABRIELLE TERESA
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:TERESA
Last Name:SHERMANSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 WELLES ST STE 128
Mailing Address - Street 2:
Mailing Address - City:FORTY FORT
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4961
Mailing Address - Country:US
Mailing Address - Phone:570-714-6657
Mailing Address - Fax:570-214-7342
Practice Address - Street 1:190 WELLES ST STE 198
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4968
Practice Address - Country:US
Practice Address - Phone:570-714-6420
Practice Address - Fax:570-714-6601
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000619170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS