Provider Demographics
NPI:1790046365
Name:ANDRADE, GABRIELA (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:ANDRADE
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 1:30 WASHINGTON AVE STE E1
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-3341
Mailing Address - Country:US
Mailing Address - Phone:856-300-2661
Mailing Address - Fax:844-927-4904
Practice Address - Street 1:30 WASHINGTON AVE STE E1
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-3341
Practice Address - Country:US
Practice Address - Phone:856-300-2661
Practice Address - Fax:844-927-4904
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455961208000000X
390200000X
PAMT2094592084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program