Provider Demographics
NPI:1134491624
Name:GABRIEL, BERNARD DELA CUESTA JR (RN)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:DELA CUESTA
Last Name:GABRIEL
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 36TH ST
Mailing Address - Street 2:APT. 10
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4735
Mailing Address - Country:US
Mailing Address - Phone:347-804-9230
Mailing Address - Fax:
Practice Address - Street 1:312 36TH ST
Practice Address - Street 2:APT. 10
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4735
Practice Address - Country:US
Practice Address - Phone:347-804-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY625271-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse