Individual
DR. GABRIELLE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
SUNY PUTNAM HALL RM 103, STONY BROOK, NY 11794-0001
(631) 632-8850
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 632-8850
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
163458
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00916138
—
NY
Enumeration date
06/08/2006
Last updated
12/02/2013
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