Provider Demographics
NPI:1881226983
Name:D'AMODIO, GABRIELLA MARIA (MS)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARIA
Last Name:D'AMODIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MARTINSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2709
Mailing Address - Country:US
Mailing Address - Phone:908-647-5555
Mailing Address - Fax:
Practice Address - Street 1:131 MARTINSVILLE RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2709
Practice Address - Country:US
Practice Address - Phone:908-647-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program