Provider Demographics
NPI:1750466124
Name:ELSTON-FERRY, GABRIELE P (NP)
Entity Type:Individual
Prefix:
First Name:GABRIELE
Middle Name:P
Last Name:ELSTON-FERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6502
Mailing Address - Country:US
Mailing Address - Phone:413-442-1019
Mailing Address - Fax:413-447-8521
Practice Address - Street 1:20 ELM ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6502
Practice Address - Country:US
Practice Address - Phone:413-442-1019
Practice Address - Fax:413-447-8521
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA185597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S35147Medicare UPIN
MANP1984Medicare ID - Type Unspecified