Provider Demographics
NPI:1588456099
Name:STAUFFER, GABRIELLE (NP)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 FLUSHING AVE # 5G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4106
Mailing Address - Country:US
Mailing Address - Phone:315-481-7643
Mailing Address - Fax:
Practice Address - Street 1:44 W 28TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4212
Practice Address - Country:US
Practice Address - Phone:212-545-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407549363LP0808X
CT196427163WP0808X
NY931254163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health