Provider Demographics
NPI:1659962926
Name:AMATO, GABRIELLA N (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:N
Last Name:AMATO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RADCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2261
Mailing Address - Country:US
Mailing Address - Phone:617-840-4552
Mailing Address - Fax:
Practice Address - Street 1:105 DAVIS STRAITS
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-3909
Practice Address - Country:US
Practice Address - Phone:508-540-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist