Provider Demographics
NPI:1780689620
Name:BRIGGS, GABRIEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 W GENESEE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2162
Mailing Address - Country:US
Mailing Address - Phone:315-487-8278
Mailing Address - Fax:315-487-8273
Practice Address - Street 1:5415 W GENESEE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2162
Practice Address - Country:US
Practice Address - Phone:315-487-8278
Practice Address - Fax:315-487-8273
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0268161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0268161OtherNY STATE LISENCE
NY0268161OtherNY STATE LISENCE