Provider Demographics
NPI:1689933566
Name:SANABRIA, GLORIA (LPN)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 MAIN ST.
Mailing Address - Street 2:C/O WELLNESS HOME CARE
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924
Mailing Address - Country:US
Mailing Address - Phone:845-294-8364
Mailing Address - Fax:845-294-8966
Practice Address - Street 1:252 MAIN ST.
Practice Address - Street 2:WELLNESS HOME CARE
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-294-8364
Practice Address - Fax:845-294-8966
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260659-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse