Provider Demographics
NPI:1811198740
Name:ABELARD, GABRIELLE P (PMHCNS, BC)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:P
Last Name:ABELARD
Suffix:
Gender:F
Credentials:PMHCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 PEARL ST.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072
Mailing Address - Country:US
Mailing Address - Phone:781-344-0057
Mailing Address - Fax:781-344-0027
Practice Address - Street 1:450 PEARL ST.
Practice Address - Street 2:SUITE 3
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072
Practice Address - Country:US
Practice Address - Phone:781-344-0057
Practice Address - Fax:781-344-0027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231520363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0002520Medicare UPIN