Provider Demographics
NPI:1629069943
Name:GABRIEL, ESMAT M (EDD)
Entity Type:Individual
Prefix:
First Name:ESMAT
Middle Name:M
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 BEDFORD LN
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6339
Mailing Address - Country:US
Mailing Address - Phone:215-362-5678
Mailing Address - Fax:215-362-7281
Practice Address - Street 1:521 MOREDON RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-7705
Practice Address - Country:US
Practice Address - Phone:215-914-4195
Practice Address - Fax:215-914-4179
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional