Provider Demographics
NPI:1326039934
Name:JANO, GABRIELA (DO)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:JANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 GAYNOR AVE
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1916
Mailing Address - Country:US
Mailing Address - Phone:516-333-3253
Mailing Address - Fax:516-333-8452
Practice Address - Street 1:355 POST AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2265
Practice Address - Country:US
Practice Address - Phone:516-333-3253
Practice Address - Fax:516-333-8452
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217015208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH71276Medicare UPIN
NY0184J1Medicare ID - Type Unspecified