Provider Demographics
NPI:1316552268
Name:CARPENTER, GABRIELLE A
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLE
Middle Name:A
Last Name:CARPENTER
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 1:42 HILL ST
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1327
Mailing Address - Country:US
Mailing Address - Phone:120-134-3139
Mailing Address - Fax:
Practice Address - Street 1:42 HILL ST
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1327
Practice Address - Country:US
Practice Address - Phone:120-134-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife