Provider Demographics
NPI:1619943875
Name:ARIOLA, GABRIEL R (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:R
Last Name:ARIOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-3510
Mailing Address - Country:US
Mailing Address - Phone:631-728-4500
Mailing Address - Fax:
Practice Address - Street 1:240 W MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-3510
Practice Address - Country:US
Practice Address - Phone:631-728-4500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151856207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE36429Medicare UPIN
NY80F921Medicare ID - Type Unspecified