Provider Demographics
NPI:1184785131
Name:KUCZMARSKI, GABRIELLE CHRISTA (PT)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:CHRISTA
Last Name:KUCZMARSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SOUTH RAINBOW BLVD
Mailing Address - Street 2:APT 2010
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139
Mailing Address - Country:US
Mailing Address - Phone:716-983-7255
Mailing Address - Fax:
Practice Address - Street 1:5400 SOUTH RAINBOW BLVD
Practice Address - Street 2:SPRING VALLEY HOSPITAL REHAB UNIT
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118
Practice Address - Country:US
Practice Address - Phone:702-853-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist