Provider Demographics
NPI:1780019125
Name:PIRENO, GABRIELLA MARISSA
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARISSA
Last Name:PIRENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GOLD ST APT 15N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1842
Mailing Address - Country:US
Mailing Address - Phone:917-804-0334
Mailing Address - Fax:
Practice Address - Street 1:90 GOLD ST APT 15N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1842
Practice Address - Country:US
Practice Address - Phone:917-804-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist