Provider Demographics
NPI:1275383366
Name:SALAS, GABRIELA A (APN)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:A
Last Name:SALAS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 FRANKLIN TPKE STE 6A
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1836
Mailing Address - Country:US
Mailing Address - Phone:551-998-0079
Mailing Address - Fax:
Practice Address - Street 1:140 FRANKLIN TPKE STE 6A
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1836
Practice Address - Country:US
Practice Address - Phone:201-447-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15143300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily