Provider Demographics
NPI:1669842092
Name:BISCOTTINI, GABRIELA (ATC, LAT)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:BISCOTTINI
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1738
Mailing Address - Country:US
Mailing Address - Phone:551-404-5669
Mailing Address - Fax:
Practice Address - Street 1:45 WILLOW ST APT 232
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1978
Practice Address - Country:US
Practice Address - Phone:551-404-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer