Provider Demographics
NPI:1679204887
Name:IMPERATO, GABRIELLA MARIE (MS CF SLP)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARIE
Last Name:IMPERATO
Suffix:
Gender:F
Credentials:MS CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A SHERWOOD PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2352
Mailing Address - Country:US
Mailing Address - Phone:347-308-2866
Mailing Address - Fax:
Practice Address - Street 1:1A SHERWOOD PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2352
Practice Address - Country:US
Practice Address - Phone:347-308-2866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist