Provider Demographics
NPI:1497430565
Name:HARY, GABRIELLE ROSE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:ROSE
Last Name:HARY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 CONVERY BLVD
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-2525
Mailing Address - Country:US
Mailing Address - Phone:732-442-1170
Mailing Address - Fax:
Practice Address - Street 1:763 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2525
Practice Address - Country:US
Practice Address - Phone:732-442-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02172800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist