Provider Demographics
NPI:1093522203
Name:INGRASSIA, GABRIELLA (AUD)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:INGRASSIA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 N VILLAGE AVE STE 1C
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3800
Mailing Address - Country:US
Mailing Address - Phone:516-678-1804
Mailing Address - Fax:516-280-3568
Practice Address - Street 1:176 N VILLAGE AVE STE 1C
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3800
Practice Address - Country:US
Practice Address - Phone:516-678-1804
Practice Address - Fax:516-280-3568
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1400074468237600000X
NY3290231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter