Provider Demographics
NPI:1659234862
Name:SADKHIN, GABRIELLE VICTORIA (LAC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:VICTORIA
Last Name:SADKHIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PELICAN CIR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4568
Mailing Address - Country:US
Mailing Address - Phone:917-900-7234
Mailing Address - Fax:
Practice Address - Street 1:125 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1068
Practice Address - Country:US
Practice Address - Phone:917-900-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002302171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty