Provider Demographics
NPI:1568838332
Name:SCHNEIDER, GABRIELLE (PT)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 BROADWAY
Mailing Address - Street 2:SUITE 710
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-5242
Mailing Address - Country:US
Mailing Address - Phone:212-941-0503
Mailing Address - Fax:212-941-6195
Practice Address - Street 1:584 BROADWAY
Practice Address - Street 2:SUITE 710
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-5242
Practice Address - Country:US
Practice Address - Phone:212-941-0503
Practice Address - Fax:212-941-6195
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039040OtherNY STATE LICENSE