Individual
GABRIELLE BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2263 STATE HIGHWAY 310, MADRID, NY 13660-3224
(315) 322-8947
(315) 713-5246
Mailing address
2263 STATE HIGHWAY 310, MADRID, NY 13660-3224
(315) 322-8947
(315) 713-5246
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018647
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04169751
—
NY
Enumeration date
06/17/2015
Last updated
04/20/2022
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