Provider Demographics
NPI:1437644622
Name:HALLER, GABRIEL (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:HALLER
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S ADELAIDE AVE APT 2M
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1661
Mailing Address - Country:US
Mailing Address - Phone:732-406-1087
Mailing Address - Fax:
Practice Address - Street 1:30 S ADELAIDE AVE APT 2M
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1661
Practice Address - Country:US
Practice Address - Phone:732-406-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist