Provider Demographics
NPI:1427509520
Name:GEIB, GABRIELLE MARIE CAPONIGRO (LAC)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:MARIE CAPONIGRO
Last Name:GEIB
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:GABRIELLE
Other - Middle Name:MARIE
Other - Last Name:CAPONIGRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 WATERLOO AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1731
Mailing Address - Country:US
Mailing Address - Phone:610-203-3747
Mailing Address - Fax:
Practice Address - Street 1:6 WATERLOO AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1731
Practice Address - Country:US
Practice Address - Phone:610-203-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001199171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist