Provider Demographics
NPI:1114972049
Name:PINZON, GABRIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:
Last Name:PINZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ROUTE 34 S
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2415
Mailing Address - Country:US
Mailing Address - Phone:732-431-1616
Mailing Address - Fax:732-866-7962
Practice Address - Street 1:24 ROUTE 34 S
Practice Address - Street 2:SUITE D-2
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2415
Practice Address - Country:US
Practice Address - Phone:732-431-1616
Practice Address - Fax:732-866-7962
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07670600207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
L58053Medicare UPIN