Provider Demographics
NPI:1245249937
Name:GABEL, JONATHAN (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:GABEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:125 RED CREEK DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4272
Mailing Address - Country:US
Mailing Address - Phone:585-321-0110
Mailing Address - Fax:585-334-6373
Practice Address - Street 1:125 RED CREEK DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4272
Practice Address - Country:US
Practice Address - Phone:585-321-0110
Practice Address - Fax:585-334-6373
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY257476207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03239961Medicaid