Provider Demographics
NPI:1710629787
Name:DELORENZE, GABRIELLA (ATC)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:DELORENZE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 PEPPERIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-1941
Mailing Address - Country:US
Mailing Address - Phone:860-575-5778
Mailing Address - Fax:
Practice Address - Street 1:43 PEPPERIDGE AVE
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-1941
Practice Address - Country:US
Practice Address - Phone:860-575-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174H00000XOther Service ProvidersHealth Educator