Provider Demographics
NPI:1417629023
Name:KILLIAN, GABRIEL (CRPA-P)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:CRPA-P
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:KILLIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:768 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2006
Mailing Address - Country:US
Mailing Address - Phone:716-882-3151
Mailing Address - Fax:716-886-4002
Practice Address - Street 1:768 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2006
Practice Address - Country:US
Practice Address - Phone:716-882-3151
Practice Address - Fax:716-886-4002
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist