Provider Demographics
NPI:1609017458
Name:GABRIEL MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:GABRIEL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-620-4368
Mailing Address - Street 1:55 MERELINE AVE REAR
Mailing Address - Street 2:P.O. BOX 2226
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-3033
Mailing Address - Country:US
Mailing Address - Phone:973-620-4368
Mailing Address - Fax:973-341-9665
Practice Address - Street 1:55 MERELINE AVE REAR
Practice Address - Street 2:
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-3033
Practice Address - Country:US
Practice Address - Phone:973-620-4368
Practice Address - Fax:973-341-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-07
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies