Provider Demographics
NPI:1255056768
Name:IRIZARRY, GABRIELA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:L
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N BROADWAY STE 704
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2320
Mailing Address - Country:US
Mailing Address - Phone:914-385-1150
Mailing Address - Fax:
Practice Address - Street 1:1 N BROADWAY STE 704
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2320
Practice Address - Country:US
Practice Address - Phone:914-385-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024599-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist