Individual
VIVIANA GAVELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 CONEY ISLAND AVE, SUITE 414, BROOKLYN, NY 11230-2344
(718) 434-1200
(718) 434-1099
Mailing address
6261 BOOTH ST, FLOOR 2, REGO PARK, NY 11374-1561
(646) 234-5063
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
210385
NY
252Y00000X
Early Intervention Provider Agency
Primary
210385
NY
Other
Enumeration date
12/15/2013
Last updated
12/08/2016
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