Provider Demographics
NPI:1467982983
Name:NIEBLER, GWENDOLYN ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:ELIZABETH
Last Name:NIEBLER
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 1:246 BALMORAL CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-1215
Mailing Address - Country:US
Mailing Address - Phone:484-566-0317
Mailing Address - Fax:
Practice Address - Street 1:246 BALMORAL CT
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-1215
Practice Address - Country:US
Practice Address - Phone:484-566-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0047812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology