Individual
MR. BRYAN GABRIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2967 POND RD, WANTAGH, NY 11793-1700
(646) 208-3826
Mailing address
2967 POND RD, WANTAGH, NY 11793-1700
(646) 208-3826
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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