Provider Demographics
NPI:1740036581
Name:FARLEY, GABRIELLE J (MD)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:J
Last Name:FARLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 S SHAW LN
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1812
Mailing Address - Country:US
Mailing Address - Phone:513-504-8718
Mailing Address - Fax:
Practice Address - Street 1:400 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6205
Practice Address - Country:US
Practice Address - Phone:602-839-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program