Provider Demographics
NPI:1750141461
Name:PEDRERO-DAVILA, GABRIELA (PHD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:PEDRERO-DAVILA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 53RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2704
Mailing Address - Country:US
Mailing Address - Phone:917-202-8555
Mailing Address - Fax:
Practice Address - Street 1:469 53RD ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2704
Practice Address - Country:US
Practice Address - Phone:917-202-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003142103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst