Provider Demographics
NPI:1063911378
Name:COHEN, GABRIELLE (DC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 RIVERSIDE ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1396
Mailing Address - Country:US
Mailing Address - Phone:603-880-4150
Mailing Address - Fax:603-880-6765
Practice Address - Street 1:29 RIVERSIDE ST UNIT B
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062
Practice Address - Country:US
Practice Address - Phone:603-880-4150
Practice Address - Fax:603-880-6765
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor