Provider Demographics
NPI:1104514165
Name:O'SHEA, GABRIELA (MED)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 MARVINE AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4518
Mailing Address - Country:US
Mailing Address - Phone:717-572-5472
Mailing Address - Fax:
Practice Address - Street 1:8500 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3317
Practice Address - Country:US
Practice Address - Phone:717-572-5472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health