Provider Demographics
NPI:1316152671
Name:MCANDREWS, GABRIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CROOKED OAK RD
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1120
Mailing Address - Country:US
Mailing Address - Phone:631-331-9083
Mailing Address - Fax:631-331-9083
Practice Address - Street 1:20 CROOKED OAK RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777
Practice Address - Country:US
Practice Address - Phone:631-331-9083
Practice Address - Fax:631-331-9083
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013610-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVL7401Medicare ID - Type Unspecified