Provider Demographics
NPI:1912221482
Name:GABRIEL, ALEX (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 W RAMAPO RD
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-2011
Mailing Address - Country:US
Mailing Address - Phone:845-786-3402
Mailing Address - Fax:845-786-2839
Practice Address - Street 1:56 W RAMAPO RD
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-2011
Practice Address - Country:US
Practice Address - Phone:845-786-3402
Practice Address - Fax:845-786-2839
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041245-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist