Provider Demographics
NPI:1619022613
Name:SHELLEY, GABRIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:SHELLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W 25TH ST
Mailing Address - Street 2:6TH FLR, STE 19
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7405
Mailing Address - Country:US
Mailing Address - Phone:212-627-1646
Mailing Address - Fax:212-627-1697
Practice Address - Street 1:138 W 25TH ST
Practice Address - Street 2:6TH FLR, STE 19
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7405
Practice Address - Country:US
Practice Address - Phone:212-627-1646
Practice Address - Fax:212-627-1697
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200608 012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry