Provider Demographics
NPI:1679532774
Name:GABRIEL, DAVID E (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1846
Mailing Address - Country:US
Mailing Address - Phone:330-759-7672
Mailing Address - Fax:330-759-7699
Practice Address - Street 1:3020 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1846
Practice Address - Country:US
Practice Address - Phone:330-759-7672
Practice Address - Fax:330-759-7699
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2977/T445152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0318098Medicaid
OH0318098Medicaid
OHT46288Medicare UPIN