Provider Demographics
NPI:1699489591
Name:MADDALO, GABRIELLE CRISTINE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:CRISTINE
Last Name:MADDALO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 CHELSEA PL
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2207
Mailing Address - Country:US
Mailing Address - Phone:215-200-1727
Mailing Address - Fax:
Practice Address - Street 1:262 TOLLGATE RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1377
Practice Address - Country:US
Practice Address - Phone:215-968-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily