Provider Demographics
NPI:1467870238
Name:SANTARELLI, GABRIELLE GENEVIEVE (DO)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:GENEVIEVE
Last Name:SANTARELLI
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 1:1991 SPROUL ROAD
Mailing Address - Street 2:SUIT 625
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008
Mailing Address - Country:US
Mailing Address - Phone:610-325-0309
Mailing Address - Fax:
Practice Address - Street 1:1991 SPROUL RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3512
Practice Address - Country:US
Practice Address - Phone:610-325-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018801207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine