Provider Demographics
NPI:1417631433
Name:GABTEL HEALTH CARE LLC
Entity Type:Organization
Organization Name:GABTEL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:PERPETUA
Authorized Official - Middle Name:NNENNA
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP/PMHNP
Authorized Official - Phone:240-645-3674
Mailing Address - Street 1:11905 FROST DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4430
Mailing Address - Country:US
Mailing Address - Phone:240-645-3674
Mailing Address - Fax:
Practice Address - Street 1:20 MAYO RD STE 201
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1442
Practice Address - Country:US
Practice Address - Phone:240-645-3674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GABTEL HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-12
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty